Nonsurgical Management of Live Tubal Ectopic Pregnancy by Ultrasound-Guided Local Injection and Systemic Methotrexate

Wang, Mingyi; Chen, Biliang; Wang, Jian; Ma, Xiaolong; Wang, Yu

doi:10.1016/j.jmig.2014.01.009

Cited by 17 publications

(20 citation statements)

References 31 publications

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“…Study shows effective resolution of sacs when MTX used simultaneously in systemic and local intragestational route in spite of high â hCG level (12,000 to 46,000 mIU/mL) 18,21,23,24 2. KCL: Injection of embryonic intracardiac KCL is equally effective (95.2%) as combined systemic and local MTX injection (93.3%).…”

Section: Combined Systemic and Local Methotrexatementioning

confidence: 91%

“…Expectant treatment: It is not justified in cervical ectopic like other ectopic as there is increased risk of uterine rupture, severe haemorrhage and disseminated intravascular coagulation that mandate hysterectomy 6,19,20 Medical treatment: If cases are diagnosed at early weeks of gestational age and when serum â hCG level lies within 5,000 mIU/mL complete and uncomplicated resolution is possible by medical treatment within a few months. 2,18,21,22 Other studies shows successful medical treatment of both tubal and cervical ectopic pregnancies in-spite of high â hCG 23,24 . Injection methotrexate and KCL is usually used for medical treatment.…”

Section: Managementmentioning

confidence: 99%

“…KCL: Injection of embryonic intracardiac KCL is equally effective (95.2%) as combined systemic and local MTX injection (93.3%). 23,24 Surgical treatment: Laparotomy or Laparoscopyfollowed by wedge excision of gestational mass is safe therapy, particularly in advanced pregnancy. 6 The follow-up period usually shorter than with medical treatment, and the risk of uterine rupture or recurrence at the site of repair is less likely.…”

Section: Combined Systemic and Local Methotrexatementioning

confidence: 99%

See 2 more Smart Citations

Caesarean Scar Ectopic Pregnancy Treated with local Methotrexate: A Case Report

Sultana

Dewan

Kazal

et al. 2016

Bangladesh J Obstet Gynaecol

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Ectopic pregnancy in a caesarean scar is the rarest form of ectopic pregnancy and probably the most dangerous one because of the risk of uterine rupture and massive hemorrhage. Since the advent of endovaginal ultrasonography, ectopic pregnancy in a caesarean scar can be diagnosed and distinguished from cervical pregnancy early in pregnancy. Here we describe a case of ectopic pregnancy in a caesarean scar in which the diagnosis was done at 6 weeks of pregnancy by transvaginal sonography and confirmed by MRI. The case was successfully managed by ultrasonography guided local injection of methotrexate into the gestational sac through trans abdominal route.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 43-48

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Section: Combined Systemic and Local Methotrexatementioning

confidence: 91%

Section: Managementmentioning

confidence: 99%

Section: Combined Systemic and Local Methotrexatementioning

confidence: 99%

See 1 more Smart Citation

Caesarean Scar Ectopic Pregnancy Treated with local Methotrexate: A Case Report

Sultana

Dewan

Kazal

et al. 2016

Bangladesh J Obstet Gynaecol

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“…It can be medical, surgical with conservation, or not depending on the localization of pregnancy, the status of fallopian tube during the diagnosis, and the need of future pregnancy [ 8 ]. Usually, a surgical act is needed; the medical treatment is for particular circumstances [ 12 , 13 ]. Salpingotomy is often preferred to salpingectomy in order to conserve the fertility although there is little evidence which supports that management [ 14 ].…”

Section: Commentsmentioning

confidence: 99%

Bilateral Tubal Pregnancy without Known Risk Factor

Zamané

Yameogo

Kain

et al. 2017

Case Reports in Obstetrics and Gynecology

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Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected. A laparotomy in emergency confirmed the diagnosis of bilateral ectopic gestation with a right ampullary unruptured pregnancy and a left isthmic ruptured gestation. A bilateral salpingectomy was performed and counseling was made for the use of medical help of procreation in case of future need of pregnancy.

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“…Grossesse ectopique autre que tubaire [15][16][17][18][19][20][21][22][23][24][25] Interstitielle Aux vues des données publiées à ce jour (NP4), le recours au méthotrexate en première intention par voie intramusculaire ou par voie in situ est une option théra-peutique acceptable pour les grossesses interstitielles non compliquées compte tenu des risques opératoires hémor-ragiques non négligeables en chirurgie et des risques obstétricaux d'une résection de corne utérine (Grade C).…”

Section: Selon Les Antécédentsunclassified