Tubal Rupture After Decrease Of β-hCG Near To Zero In Ectopic Pregnancy, A Case Report

Year 2015, Volume: 12 Issue: 6, 226 - 227, 01.12.2015

Ebru Ersoy Ali Özgür Ersoy Şevki Çelen Esra Yaşar Çelik Yeliz Dönmez

Abstract

A 30 years old woman was diagnosed as ectopic pregnancy and β-hCG beta subunit of human chorionic gonadotropin hormone titer was 8696 mIU/ml. She was treated with methotrexate, as outpatient treatment. During follow-up ultrasonographic examinations and laboratory tests, she continued routine normal life. On 41st day of treatment, she admitted to emergency room with an acute abdominal hemorrhage. During laparotomic investigation, rupture on the posterior wall of left salphinx was determined and left salpingectomy was performed.

Keywords

Ectopic pregnancy, methotrexate, β-hCG, rupture

β-hCG Sıfırlanmasına Yakın Dönemde Tubal Rüptür Gözlenen Ektopik Gebelik, Olgu Sunumu

Abstract

Ektopik gebelik teşhisi konulan ve β-hCG insan koryonik gonadotropin hormonunun beta alt birimi düzeyi 8696 mIU/ml iken metotreksat tedavisi verilen 30 yaşındaki bir kadın hasta, ayaktan takip edildi. Ultrason ve laboratuar testleri ile aralıklı olarak değerlendirildi. Hasta günlük hayatına geri döndü. β-hCG düzeyleri minimal iken ve tedavinin 41. gününde hasta karşımıza akut batın içi kanama ile geldi. Operasyonda, sol tuba arka kısım rüptürü gözlendi ve sol salpenjektomi yapıldı.

Keywords

Ektopik gebelik, metotreksat, β-hCG, rüptür

References

• Centers for Disease Control and Prevention. Ectopic pregnancy—United States, 1990–1992. MMWR Morb Mortal Wkly Rep 1995;44:46–8.
• Stovall TG, Ling FW. Single dose methotrex: an expanded clinical trial. Am J Obstet Gynecol 1993;168:1759-62.
• Lipscomb GH, Bran D, McCord ML, Portera JC, Ling FW. Analysis of three hundered fifteen ectopic pregnancies treated with single-dose met- hotrexate. Am J Obstet Gynecol 1998;178: 1354-8.
• Lipscomb G, McCord M, Stovall T, Huff G, Portera S G, Ling FW. Predi- ctors of success of methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med 1999;341:1974–8.
• Alleyassin A, Khademi A, Aghahosseini M, Safdarian L, Badenoosh B, Hamed EA. Comparison of success rates in the medical management of ectopic pregnancy with sin- gle-dose and multiple-dose administration of methotrex- ate: a prospective, randomized clinical trial. Fertil Steril 2006;85:1661–6.
• Wang M, Chen B, Wang J, Ma X, Wang Y. Nonsurgical management of live tubal ectopic pregnancy by ultrasound-guided local injection and systemic methotrexate. J Minim Invasive Gynecol 2014;21:642-9.
• Lecuru F, Robin F, Chasset S, Leonard F, Guitti S, Taurelle R. Direct cost of single dose methotrexate for unruptured ectopic pregnancy. Prospe- ctive comparison with laparoscopy. Eur J Obstet Gynecol Reprod Biol 2000;88:1-6.
• Hajenius PJ, Engelsbel S, Mol BW, Van der Veen F, Ankum WM, Bos- suyt PM, Hemrika DJ, Lammes FB. Randomised trial of systemic met- hotrexate versus laparoscopic salpingostomy in tubal pregnancy. Lancet 1997;350:774-9.