A case of a methotrexate-resistant ectopic pregnancy in which dactinomycin was effective as a second-line chemotherapy.

Abstract:

OBJECTIVE:To report a case of a methotrexate (MTX)-resistant heterotopic interstitial pregnancy in which dactinomycin was necessary as a second-line chemotherapy. DESIGN:Case report. SETTING:Medical college-affiliated hospital. PATIENT(S):A 39-year-old woman with vaginal bleeding after the transfer of two thawed 8-cell embryos. INTERVENTION(S):MTX 50 mg/m(2) was given to the patient to treat a concomitant pregnancy in which an interstitial pregnancy and an intrauterine blighted ovum were identified. However, the patient's hCG level rose despite two MTX administrations. As a result, dactinomycin was then administered as a second-line chemotherapy. The patient's serum hCG level declined to a normal range after two administrations of dactinomycin. CONCLUSION(S):Dactinomycin could be an alternative in cases for which MTX is not effective and persistently high hCG levels exist.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Fujioka S,Yamashita Y,Kawabe S,Kamegai H,Terai Y,Ohmichi M

doi

10.1016/j.fertnstert.2008.10.003

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

929.e13-5

issue

3

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(08)04130-7

journal_volume

91

pub_type

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