Medical management of interstitial ectopic pregnancy: a case report and literature review |
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Authors: | Fisch JD; Ortiz BH; Tazuke SI; Chitkara U; Giudice LC |
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Institution: | Division of Reproductive Endocrinology and Infertility, Stanford University School of Medicine, California 94305, USA. |
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Abstract: | Recent reports describe successful treatment of interstitial ectopic
pregnancies using methotrexate. While the number of reported cases is
increasing, no consensus exists regarding the management of this
complication of pregnancy. We present the successful use of combined
systemic and direct intrasac injection of methotrexate for an interstitial
pregnancy with the highest yet reported initial beta-human chorionic
gonadotrophin concentration (102,000 mIU/ml). We also describe the use of
Doppler ultrasound for monitoring treatment progression. Through a review
of the current literature, we propose to facilitate management decisions
and increase outcome success by summarizing previously reported treatment
regimens and by describing enhanced parameters for patient selection and
monitoring.
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