title: Medical management of ectopic pregnancy with extremely high beta-HCG levels: a case report.
abstract: We report the successful treatment of an unruptured ectopic pregnancy in a patient with extremely high beta-human chorionic gonadotropin concentrations. A 33-year-old woman, gravida 2, para 0, abortus 1, presented to our department due to menstrual delay. On transvaginal ultrasonography, she had an unruptured ectopic pregnancy (3.5 x 4.5 cm). Her initial beta-HCG concentration was 38,270 mIU/ml. The administration of methotrexate (50 mg/m2) was performed intramuscularly. Serum beta-HCG levels decreased > 15% between post-therapy days 4 (31,324 mIU/ml) and 7 (13,108 mIU/ml), and did not rise during the subsequent weekly controls. In selected cases with unruptured ectopic pregnancy and extremely high initial beta-HCG levels, medical management with a single-dose methotrexate regimen may be successful.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Trakya University, Edirne (Turkey).
authors.forename: M A
authors.initials: MA
authors.lastname: Yüce
authors.forename: F
authors.initials: F
authors.lastname: Gücer
authors.forename: P
authors.initials: P
authors.lastname: Balkanli-Kaplan
authors.forename: N C
authors.initials: NC
authors.lastname: Sayin
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate