Interstitial pregnancy treated with local and systemic methotrexate.
We present a case of an intact interstitial pregnancy at 6 postmenstrual weeks and 4 days, which was successfully treated by combined local and systemic methotrexate administration. The embryonic cardiac activity stopped within 1 min after uneventful ultrasound-guided puncture and methotrexate instillation of the chorionic sac. While the beta-hCG serum values returned to normal 59 days after local, and 52 days after systemic treatment, the echogenic lesion has reduced in size by 50%, but is still sonographically detectable 7 months after the procedure. This report shows that medical treatment of interstitial pregnancy may be an effective alternative to the surgical approach.
De Bruyne
F
F
Department of Obstetrics and Gynaecology, Heinrich Heine University, Düsseldorf, Germany. bruyne@uni-duesseldorf.de
Tutschek
B
B
Hucke
J
J
Crombach
G
G
D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D005318:Fetal Heart / Q000187:drug effects; D005493:Folic Acid Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014463:Ultrasonography
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005493:Folic Acid Antagonists; D008727:Methotrexate