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.
Department of Obstetrics and Gynaecology, Heinrich Heine University, Düsseldorf, Germany. bruyne@uni-duesseldorf.de
F
F
De Bruyne
B
B
Tutschek
J
J
Hucke
G
G
Crombach
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