2016, Number 05
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Ginecol Obstet Mex 2016; 84 (05)
Multidose treatment of methotrexate in cornual ectopic pregnancy
Pantoja-Garrido M, Cabezas-Palacios MN, Tato-Varela S
Language: Spanish
References: 14
Page: 319-323
PDF size: 477.87 Kb.
ABSTRACT
Background: Ectopic pregnancy represents a common entity when
the differential diagnosis of first trimester pathologies is performed. Extratubal
location, nonetheless, is an in unfrequent situation that delays
and difficults the diagnoses.
Case Report: 41-year-old women who goes to clinic for a pregnancy
test, which proved positive done. During normal ultrasonographic we
observed attached with endometrial 8 mm thick, without gestational
sac inside, no free liquid in the bottom of the pouch of Douglas. In the
left cornual region had a suggestive image of ectopic pregnancy, of 2.8
cm, with embryo without cardiac activity, tested with Doppler color,
according to 6 weeks of amenorrhea was observed. The level of β-HCG
was 17,656 mU/mL, which confirmed the diagnosis of corneal ectopic
pregnancy. Multidose protocol of methotrexate and folinic acid was
prescribed at a dose of 50 mg on days 1, 3, 5 and 7, and 5 mg in the
days 2, 4, 6 and 8, respectively. After 14 days of treatment a new β-HCG
study control was made, which results was 2,519 mU/mL. From that
time we take a weekly control studies of the β-HCG until was negative
(six months later). The multidose protocol of methotrexate and folinic
acid is an effective treatment in patients with cornual ectopic pregnancy.
REFERENCES
Kun WM, Tung WK. On the look out for a rarity interstitial/ cornual pregnancy. Eur J Emerg Med 2001;8(2):147-50.
San Román M.V, Andía D, Lobato J.L, et al. Tratamiento conservador del embarazo ectópico cornual. Prog Obstet Ginecol 2006;49(3):139-43.
Buxant F, Ansion MH, Noël JC , Anaf V, Simon P. Laparoscopic management of a cornual ectopic pregnancy .Gynecol Surg 2005(2):197-200.
Hadisaputra W. A cornual ectopic pregnancy case: diagnosis, etiology and its management. Med J Indones 2008;18:64-8.
Filly RA: Ectopic pregnancy, in Callen PW (Ed): Ultrasonography in Obstetrics and Gynecology. 3rd ed. Philadelphia: W. B. Saunders, 1994;641-659.
Lau S, Tulandi T. Conservative medical and surgical management of interstitial ectopic pregnancy. Fertil Steril 1999;72(2):207-15.
Maruthini D, Sharma V. A Case of Live Birth after Uterine Reconstruction for Recurrent Cornual Ectopic Pregnancy following IVF Treatment. Case Rep Obstet Gynecol 2013;2013:625261.
Faraj R, Steel M. Management of cornual (interstitial) pregnancy. Obst Gynaecol 2007;9:249-255.
Emery A, Buentipo B. Sonographic detection of cornual ectopic pregnancy. J Diagn Med Sonog 2008;24:252-256.
Stovall TG, Ling FW. Ectopic pregnancy: diagnostic and therapeutic algorithms minimizing surgical intervention. J Reprod Med 1993;38:807-12.
Onderoglu LS, Salman MC, Ozyuncu O, Bozdag G. Successful management of a cornual pregnancy with a single highdose laparoscopic methotrexate injection. Gynecol Surg 2006;3:31-33.
Lipscomb GH, Givens VM, Meyer NL et al. Comparison of multidose and single-dose methotrexate protocols for the treatment of ectopic pregnancy. Am J Obstet Gynecol 2005;192(6):1844-8.
Alleyassin A, Khademi A, Aghahosseini M et al. Comparison of success rates in the medical management of ectopic pregnancy with single-dose and multiple-dose administration of methotrexate: a prospective, randomized clinical trial. Fertil Steril 2006;85(6):1661-6.
SEGO. Protocolo embarazo ectópico. Prog Obstet Ginecol 2007;50(6):377-85.