Treatment of ectopic pregnancy with single-dose methotrexate in a patient with an intrauterine device. A case report.
BACKGROUND
Medical therapy for ectopic pregnancy is successful in 86-100% of selected patients. Patients who conceive with an intrauterine device (IUD) in place have an increased risk of ectopic pregnancy (30% of conceptions); these patients have been treated routinely by surgery.


METHODS
A 33-year-old woman at 7 weeks' gestation with a copper-containing IUD in place presented with an ectopic pregnancy based on transvaginal ultrasound, quantitative beta-human chorionic gonadotropin and physical examination findings. Because she desired to keep her IUD and avoid surgery, she was treated with intramuscular single-dose methotrexate.


CONCLUSIONS
This case was the first reported successful medical treatment of an ectopic pregnancy in a patient with an IUD. There appeared to be no adverse clinical interactions between the methotrexate and IUD.
Sites
C K
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Department of Obstetrics and Gynecology, University of Vermont, Burlington 05405, USA.
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000188:drug therapy*; D016216:Ultrasonography, Prenatal
D006063:Chorionic Gonadotropin; D008727:Methotrexate