Successful treatment of advanced interstitial pregnancy with methotrexate and hysteroscopy: A case report

Asnat Groutz*, Yoram Wolf, Benjamin Caspi, Igal Wolman, David Gordon, Menachem P. David

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Data concerning medical treatment of interstitial ectopic pregnancies are scarce. These pregnancies are characterized by late and serious clinical manifestations. We report a case of advanced interstitial pregnancy treated successfully by combining methotrexate (MTX) and hysteroscopy. CASE: A routine ultrasonic evaluation of a 10-week pregnancy revealed a right interstitial gestational sac 58 mm in diameter and containing an embryo with a crown-rump length of 29 mm and embryonic heartbeats. Serum β-human chorionic gonadatropin (hCG) level was 97,950 mIU/mL. The patient was treated with a systemic MTX/leucovorin regimen. At the end of the one-week course, no embryonic cardiac activity was detected, and a decrease in β-hCG levels commenced. Persistent trophoblastic tissue, manifested by a low (26 mIU/mL) β-hCG level in plateau, was successfully removed by way of hysteroscopy. CONCLUSION: Early detection of interstitial pregnancy amy facilitate conservative medical treatment.

Original languageEnglish
Pages (from-to)719-722
Number of pages4
JournalThe Journal of reproductive medicine
Volume43
Issue number8
StatePublished - Aug 1998

Keywords

  • Hysteroscopy
  • Methotrexate
  • Pregnancy, ectopic
  • Pregnancy, interstitial

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