title: Successful treatment of an advanced interstitial pregnancy by sequential systemic and local administration of methotrexate.
abstract: A patient is presented with an advanced interstitial pregnancy, diagnosed by transvaginal ultrasound and confirmed by laparoscopy. Amenorrhoea at the time of diagnosis was 57 days. Methotrexate was given systemically (4 x 50 mg i.m.). Because of persisting viability of the fetus, systemic methotrexate treatment was followed by local instillation of methotrexate into the gestational sac (50 mg). Follow-up revealed rapid human chorionic gonadotrophin regression but slow regression of fetal remnants.
authors.affiliation: Department of Obstetrics and Gynaecology, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Hoek
authors.forename: F J
authors.initials: FJ
authors.lastname: Broekmans
authors.forename: R H
authors.initials: RH
authors.lastname: Verheijen
authors.forename: R
authors.initials: R
authors.lastname: Schats
mesh_terms: D000287:Administration, Topical; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D004322:Drainage; D005321:Extraembryonic Membranes; D005260:Female; D005327:Fetal Resorption; D005328:Fetal Viability; D005865:Gestational Age; D006801:Humans; D007273:Injections, Intramuscular; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D011677:Punctures; D014463:Ultrasonography
chemical_list: D006063:Chorionic Gonadotropin; D008727:Methotrexate