Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

Abstract:

BACKGROUND:Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. CASE:We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. CONCLUSION:Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.

journal_name

Obstet Gynecol

authors

Swank ML,Harken TR,Porto M

doi

10.1097/AOG.0b013e31828d58ee

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

461-464

issue

2 Pt 2

eissn

0029-7844

issn

1873-233X

pii

00006250-201308002-00011

journal_volume

122

pub_type

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