The Success of the Single-Dose Methotrexate Treatment in an Atypical Heterotopic Pregnancy
Abstract
Heterotopic pregnancy refers to simultaneous presence of intrauterine
and ectopic gestational sacs. Its incidence exhibits a rising trend due
to the increased use of assisted reproductive technology (ART). This
paper aims to present a rare case of tubal and cesarean scar heterotopic
pregnancy that occurred following a spontaneous pregnancy. The patient
presenting with delayed menstruation and abdominal-inguinal pain was
evaluated. Transvaginal ultrasonography revealed a gestational sac
located in the scar of a previous cesarean section and in the left tubal
region corresponding to a gestational age of 4 weeks and 5 days. The
patient was hospitalized and informed about conservative and surgical
methods. Then, she was administered a single dose of methotrexate 75 mg
intramuscularly. Post-operative period included ultrasonographic and
laboratory follow-up. In conclusion, it should be remembered that
single-dose systemic methotrexate therapy might constitute an
alternative to surgery in unruptured hemodynamically stable cases. J Clin Exp Invest 2016; 7 (2): 200-202
Keywords
Kaynakça
- 1. Evsen MS, Soydinç HE. Acil jinekolojik operasyonlar: 105 olgunun değerlendirilmesi. J Clin Exp Invest. 2010;1:12-5. 2. Telci S, Kaya C, Yasar L, Ekin M. Spontaneous heterotopic pregnancy causing tubal rupture in a patient with intrauter - ine device in-situ. Bakırköy Tıp Dergisi 2014;10:121-123. 3. Luo X, Lim CE, Huang C, et al. Heterotopic pregnancy fol - lowing in vitro fertilization and embryo transfer: 12 cases report. Arch Gynecol Obste. 2009;280:325-9. 4. Hassiakos D, Bakas P, Pistofidis G, Creatsas G. Hetero - topic pregnancy at 16 weeks of gestation after in-vitro fertilization and embryo transfer. Arch Gynecol Obstet. 2002;266:124-5. 5. Tal J, Haddad S, Gordon N, Timor-Tritsch I. Heterotopic pregnancy after ovulation induction and assisted reproduc - tive technologies: a literature review from 1971-1993. Fer - til Steril. 1996;66:1-12. 6. Arıöz DT, Çelik F, Polat C. Heterotopik gebelik: Olağandışı bir akut batin nedeni. Kocatepe Tıp Dergisi. 2008;9:1-3. 7. Seidman DS, Levran D, Ben-Rafael Z, et al. The incidence of combined intrauterine and extrauterine pregnancy af - ter in vitro fertilization and embryo transfer. Fertil Steril. 1991;55:833-4. 8. Reece ED, Petrie RH, Sirmons MF, et al. Combined intra - uterine and extrauterine gestation: a review. Am J Obstet Gynecol. 1983;146:323-330. 9. Glassner MJ, Aron E, Eskin BA. Ovulation induction with clomiphene and rise in heterotopic pregnancies: a report of two cases. J Reprod Med. 1990;35:175-178. 10. Lavanya R, Deepika K, Madhuri P. Successful pregnancy following medical management of heterotopic pregnancy. J Hum Reprod Sci. 2009;2:35-40. 11. Baxi A, Kaushal M, Karmalkar H, et al. Successful expect - ant management of tubal heterotopic pregnancy. J Hum Re - prod Sci. 2010;3:108-10. 12. Parker J, Thompson D. Persistent ectopic pregnancy after conservation management successful treatment with single- dose intramusculer MTX. Obstet Gynecol. 1994;34:99-102. 13. Lipscomb GH, McCord Ml, Stovall TG, et al. Predictors of success of methotrexate treatment in women with tubal ectopic preganancies. N Engl J Med. 1999;341:1974-8. 14. The American College of Obstetricians and Gynecologists Medical management of tubal pregnancy. Clinical Manage - ment Guidelines, 1998; Number 3. 15. Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta analysis compar - ing’ single dose and multidose’ regimens. Obstet Gynecol. 2003;101:778-84.
Ayrıntılar
Birincil Dil
Türkçe
Konular
Sağlık Kurumları Yönetimi
Bölüm
Olgu Sunumu
Yazarlar
Serdar Başaranoğlu
Bu kişi benim
DİCLE ÜNİVERSİTESİ
Türkiye
Yayımlanma Tarihi
16 Haziran 2016
Gönderilme Tarihi
18 Mart 2016
Kabul Tarihi
12 Nisan 2016
Yayımlandığı Sayı
Yıl 2016 Cilt: 7 Sayı: 2