Laparoscopy with ultrasonographic guidance of intraamniotic methotrexate injection for ectopic pregnancy. A report of two cases.
BACKGROUND
The efficacy of laparoscopic intratubal injection of methotrexate is reportedly controversial.


METHODS
A 29-year-old woman with an interstitial-isthmic pregnancy and a 30-year-old woman with an ampullary pregnancy surrounded by dense adhesions were treated with intraamniotic injection of methotrexate with ultrasonographically guided laparoscopy (LUS). The ectopic pregnancies resolved quickly, without further intervention. The human chorionic gonadotropin concentrations were negligible by 18 and 25 days.


CONCLUSIONS
Intraamniotic methotrexate injection with LUS is an effective treatment for unruptured interstitial and tubal pregnancies in patients with dense adhesions.
Akira
S
S
Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan. s-akira@nms.ac.jp
Ishihara
T
T
Yamanaka
A
A
Takeshita
T
T
Kaseki
H
H
Araki
T
T
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D010535:Laparoscopy / Q000379:methods; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000601:surgery*; D014463:Ultrasonography
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate