Interstitial Pregnancy Treated with Local and Systemic Methotrexate

Abstract

We present a case of an intact interstitial pregnancy at 6 postmenstrual weeks and 4 days, which was successfully treated by combined local and systemic methotrexate administration. The embryonic cardiac activity stopped within 1 min after uneventful ultrasound-guided puncture and methotrexate instillation of the chorionic sac. While the β-hCG serum values returned to normal 59 days after local, and 52 days after systemic treatment, the echogenic lesion has reduced in size by 50%, but is still sonographically detectable 7 months after the procedure. This report shows that medical treatment of interstitial pregnancy may be an effective alternative to the surgical approach.

Ectopic pregnancy: triage do's and don'ts

“…Medical management of ectopic pregnancy is supported by many investigators (20,43–46). If medical management is necessary, the patient is transferred to the consultant for care.…”

“…Local infiltration of MTX into the ectopic pregnancy is also being used as a treatment, either by itself or in conjunction with systemic treatment (43). This route of treatment reduces the side effects associated with systemic treatment (41).…”