Methotrexate in Interstitial Pregnancy: A Miraculous Fertility Rescuer.
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Date
2019-10
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Publisher
International Society for Contemporary Medical Research
Abstract
Introduction: Interstitial (cornual) gestation is the mosthazardous type of ectopic, where pregnancy gets implantedin the proximal portion of tube that traverses myometrium . Itconstitutes 2-4% of all ectopic pregnancies.It poses a significantdiagnostic and therapeutic challenge and carries a greatermaternal mortality. It usually presents at a later gestation morethan 7-12 weeks .The usual clinical presentation is profuseintraabdominal bleeding and shock. Transvaginal sonographycan be helpful, but often is not conclusive.Case report: 21 year old nulliparous lady post laparascopicleft salpingo-oopherectomy, diagnosed to have a liveinterstitial ectopic pregnancy in left lateral wall of uterus withvery high levels of βhCG . She was treated with 2 cycles offolinic acid rescue regime and βhCG monitored accordingly.βhCG showed a decline of 15% initially (2365.9mIU/ml) andweekly βhCG monitored thereafter and reduced to 3.39mIU/ml within 4 months.Conclusion: Cornual resection/hysterectomy used to be thetraditional treatment for these cases. However conservativemanagement has been increasingly practiced successfullyincluding medical treatment with systemic methotrexate andlaparoscopic conservative surgery.
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Keywords
Ectopic, Interstitial ectopic Pregnancy, Methotrexate, Rescue Regime
Citation
Soman Annie, Rajendran Reshma. Methotrexate in Interstitial Pregnancy: A Miraculous Fertility Rescuer. . International Journal of Contemporary Medical Research . 2019 Oct; 6(10): j10-j12