Successful conservative treatment for advanced interstitial pregnancy. A case report.
BACKGROUND
Interstitial pregnancy is a relatively rare and life-threatening disease, occurring in 2-4% of all extrauterine pregnancies, and the maternal mortality rate is 2-2.5%. Laparoscopic surgery and, less commonly, methotrexate are the treatments of choice for interstitial pregnancy. However, there is another treatment, ultrasound-guided direct injection of etoposide, the effect and safety of which are unclear.


METHODS
In a 32-year-old woman with interstitial pregnancy at 12 weeks of gestation, ultrasound-guided direct injection of etoposide (100 mg) was used successfully after intravenous high-dose methotrexate, 300 mg (200 mg/m2), therapy failed to produce a response. The patient's posttherapeutic course was smooth. Twelve months after treatment, she conceived and later delivered a healthy infant vaginally without adverse events.


CONCLUSIONS
Ultrasound-guided direct injection of etoposide offers another choice for treating advanced interstitial pregnancy, but further study is needed to define its efficacy and safety.
Chen
Cheng-Li
CL
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
Wang
Peng-Hui
PH
Chiu
Lung-Mao
LM
Yang
Man-Li
ML
Hung
Jeng-Hsiu
JH
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D015552:Injections, Intralesional; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D018084:Ultrasonography, Interventional; D016216:Ultrasonography, Prenatal
D000020:Abortifacient Agents, Nonsteroidal; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D008727:Methotrexate