García AMI, Hernández MF, Ruvalcaba CLA

Language: Spanish
References: 20
Page: 202-205
PDF size: 934.49 Kb.

ABSTRACT

This paper reports the case of a 32-year-old female, multiparous patient, with an ectopic cervical pregnancy, treated with methotrexate double dose systemic and one intrasaccular dose administered under ecographic (ultrasound) guidance and followed by endouterine manual aspiration with successful resolution of the clinical profile, without complications. This procedure could be a secure alternative in handling an ectopic cervical pregnancy.

REFERENCES

1. Ushakov FB, Elchalal U, Aceman PJ, Schenker JG. Cervical pregnancy: past and future. Obstet Gynecol Surv 1997;52:45-59.

2. Cepni I, Ocal P, Erkan S, Erzik B. Conservative treatment of cervical ectopic pregnancy with transvaginal. Fertil Steril 2004;81:1130-1132.

3. Berg CJ, Chang J, Callaghan WM, Whitehead SJ. Pregnancy- related mortality in the United States, 1991-1997. Obstet Gynecol 2003;101:289-296.

4. Hung TH, Shau WY, Hsieh TT, Hsu JJ, Soong YK, Jeng CJ. Prognostic factors for an unsatisfactory primary methotrexate treatment of cervical pregnancy: a quantitative review. Hum Reprod 1998;13:2636-2642.

5. Raskin MM. Diagnosis of cervical pregnancy by ultrasound: a case report. Am J Obstet Gynecol 1978;130:234-235.

6. Chen D, Kligman I, Rosenwaks Z. Heterotopic cervical pregnancy successfully treated with transvaginal ultrasoundguided aspiration and cervical-stay sutures. Fertil Steril 2001;75:1030-1033.

7. Has R, Balci NC, Ibrahimoglu L, Rozanes I, Topuz S. Uterine artery embolization in a 10-week cervical pregnancy with coexisting fibroids. Int J Gynaecol Obstet 2001;72:253-258.

8. Calabresi P, Chabner BA. Antineoplastic agents. In: Gilman A, Goodman LS, Goodman A, editors. The pharmacologic basis of therapeutics, 8th ed. New York: Macmillan Publishing, 1990;1275-1276.

9. Rodi IA, Sauer MV, Gorrill MJ, Bustillo M, et al. The medical treatment of unruptured ectopic pregnancy with methotrexate and citrovorum rescue: preliminary experience. Fertil Steril 1986;46:811-813.

10. Ory SJ, Villanueva AL, Sand PK, Tamura RK. Conservative treatment of ectopic pregnancy with methotrexate. Am J Obstet Gynecol 1986;1546:1299-1306.

11. Stovall TG, Ling FW, Buster JE. Outpatient chemotherapy of unruptured pregnancy. Fertil Steril 1989;51:435-438.

12. Pisarska MD, Carson SA, Buster JE. Ectopic pregnancy. Lancet 1998;351:1115-1120.

13. Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ectopic pregnancy. N Engl J Med 2000;343:1325-1329.

14. Barnhart K, Coutifaris C, Esposito M. The pharmacology of methotrexate. Expert Opin Pharmacother 2001;2:409-417.

15. Norman JE, Thong KJ, Baird DT. Uterine contractility and induction of abortion in early pregnancy by misoprostol and mifepristone. Lancet 1991;338:1233-1236.

16. The Practice Committee of the American Society for Reproductive Medicine Medical treatment of ectopic pregnancy. Fertil Steril 2008;90:S206-S212.

17. Barnhart KT, Sammel MD, Hummel A, Jain J, Chakhtoura N, Strauss J. A novel ‘‘two dose’’ regimen of methotrexate to treat ectopic pregnancy [abstract]. Fertil Steril 2005;84(Suppl):S130.

18. Moragianni V, Hamar B, Mc Ardle C, Ryley D. Management of a cervical heterotopic pregnancy presenting with firsttrimester bleeding: case report and review of the literature Fertil Steril 2012;98:89-94.

19. Levin I, Tsafir Z, Salar N, Lessing J, Avni A, Gamzu R, Almong B. “Watchful waiting” in ectopic pregnancies: a balance between reduced success rates and less methotrexate. Fertil Steril 2011;95:1159-1160.

20. Smorgick M, Vaknin Z, Pansky M, Halperin R, et al. Combined local and systemic methotrexate treatment of viable ectopic pregnancy: outcome of 31 cases. J Clin Ultrasound 2008;36:545-550.