Conservative therapy of interstitial pregnancy with the use of methotrexate – case study

Česká verze

Authors: David Heczko; Jana Daňková Kučerová; Petr Wiecek
Authors place of work: Gynekologicko-porodnické oddělení, Nemocnice s poliklinikou Havířov, p. o.
Published in the journal: Prakt Gyn 2016; 20(3-4): 126-130
Category: Gynekologie a porodnictví

Summary

Objective:
Description of a successfull solved case with the use of methotrexate in a patient with interstitial pregnancy.

Design:
Case study.

Setting:
Department of Obstetrics and Gynecology, Hospital Havířov.

Case report:
We present a case of a twenty six years old primigravida, nullipara when her interstitial pregnancy in right corner of the uterus was confirmed by ultrasound. The patient indicated only moderate spotting, the level of β-hCG was 6 501 IU/l. We have opted for conservative procedure – single dose administration of methotrexate. The patient was monitored for twelve months, complete negative level of β-hCG and disappearing of ultrasound result occurred. After next seven months of unsuccessful attempt of conception the patient agreed with diagnostic laparoscopy and hysteroscopy procedure, physiological appearance of organs of small pelvic was found, unfortunately, fallopian tubes were bilateral not patent.

Conclusion:
In asymptomatic development of interstitial pregnancy, early diagnostics using ultrasound and possibility of monitoring of β-hCG levels the use of methotrexate is eligible as the first choice of the therapy.

Key words:
β-hCG – interstitial pregnancy – transvaginal ultrasound – use of the methotrexate

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