title: Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.
abstract: BACKGROUND
  Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior.
  
  
  METHODS
  We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception.
  
  
  CONCLUSIONS
  Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.
authors.affiliation: Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California.
authors.forename: Morgan L
authors.initials: ML
authors.lastname: Swank
authors.forename: Tabetha R
authors.initials: TR
authors.lastname: Harken
authors.forename: Manuel
authors.initials: M
authors.lastname: Porto
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D011189:Potassium Chloride / Q000627:therapeutic use; D017680:Potassium Compounds / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*; D055357:Uterine Artery Embolization; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D006063:Chorionic Gonadotropin; D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D011189:Potassium Chloride; D008727:Methotrexate