Interstitial ectopic pregnancy managed with local methotrexate.
نویسندگان
چکیده
To cite: Maçães A, Fernandes S, Rodrigues C, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015212563 DESCRIPTION A 38-year-old woman, 7 weeks and 4 days pregnant as assessed by her last menstrual period, presented to our emergency department with non-painful vaginal bleeding for 2 days. She was a gravida 2, para 1 with a history of caesarean section 12 years before. Her serum β human chorionic gonadotropin level (β-HCG) was 2776 mIU/mL. Other laboratory results, including full blood count and liver function tests, were normal. Ultrasonography showed an empty uterine cavity and a gestational sac implanted adjacent to the right lateral aspect of the uterine cavity, surrounded by a thin myometrial layer (figure 1), containing a live embryo with bradycardia. These findings confirmed the presence of a right interstitial ectopic pregnancy. The patient was given a local injection of 25 mg of methotrexate plus 2 mEq of potassium chloride transabdominally, under ultrasound guidance (figure 2). Potassium chloride was used to arrest the embryonic heart action. The patient tolerated the procedure well and no side effects were reported. Serum β-HCG peaked at 3363 mIU/mL on the third day and then started declining. On follow-up 2 months later, the patient was asymptomatic, her β-HCG level was negative and ultrasound resolution was achieved (figure 3). Interstitial pregnancy is a rare occurrence and remains one of the most difficult ectopic pregnancies to identify. Ultrasound criteria for the diagnosis
منابع مشابه
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ورودعنوان ژورنال:
- BMJ case reports
دوره 2015 شماره
صفحات -
تاریخ انتشار 2015