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Archives of Gynecology and Obstetrics

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01-02-2012 | Reproductive Medicine

Management of ectopic pregnancies with poor prognosis through ultrasound guided intrasacular injection of methotrexate, series of 14 cases

Authors: María P. Andrés, José M. Campillos, María Lapresta, Isabel Lahoz, Raquel Crespo, Javier Tobajas

Published in: Archives of Gynecology and Obstetrics | Issue 2/2012

Abstract

Purpose

The purpose of this study is to describe our experience in cases of tubal ectopic pregnancy with heartbeat, abdominal, interstitial (corneal) and cervical ectopic pregnancies treated with intrasacular injection of methotrexate (MTX) administered under ultrasound guidance associated with a single systemic dose of MTX.

Methods

Descriptive retrospective study of 14 cases of extrauterine pregnancies treated with intrasacular injection of MTX under ultrasound control, attended in the Maternal-Fetal Medicine Unit of the Miguel Servet University Hospital, in Zaragoza, Spain, between January of 2009 and June of 2010.

Results

Of the 14 ectopic pregnancies, 7 were tubal with heartbeat, 3 cornual, 2 cervical and 2 abdominal. The average gestational age was 7 + 3 weeks and the average β-hCG value on the date of puncture was 22,885.69 mIU/mL. Surgical treatment was required in two cases, the first due to post-puncture haemoperitoneum and the second as a consequence of the rupture of the corneal ectopic pregnancy. In post-treatment monitoring, an asymptomatic increase of β-hCG on the seventh day post-puncture was observed in two cases. The success rate of the treatment was 92.96%.

Conclusions

Ultrasound guided intrasacular injection of MTX associated with a systemic dose adjusted to the body surface of the patient is a minimally invasive, safe and effective treatment in the cases of tubal ectopic pregnancy with heartbeat, abdominal, cornual or cervical ectopic pregnancy.

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Title: Management of ectopic pregnancies with poor prognosis through ultrasound guided intrasacular injection of methotrexate, series of 14 cases
Authors: María P. Andrés
José M. Campillos
María Lapresta
Isabel Lahoz
Raquel Crespo
Javier Tobajas
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 2/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-011-2044-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of ectopic pregnancies with poor prognosis through ultrasound guided intrasacular injection of methotrexate, series of 14 cases

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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