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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| Affiliation: | 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 ectopicpregnancies using methotrexate. While the number of reported cases isincreasing, no consensus exists regarding the management of thiscomplication of pregnancy. We present the successful use of combinedsystemic and direct intrasac injection of methotrexate for an interstitialpregnancy with the highest yet reported initial beta-human chorionicgonadotrophin concentration (102,000 mIU/ml). We also describe the use ofDoppler ultrasound for monitoring treatment progression. Through a reviewof the current literature, we propose to facilitate management decisionsand increase outcome success by summarizing previously reported treatmentregimens and by describing enhanced parameters for patient selection andmonitoring. |
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