Ultrasound-Guided Injection of Ectopic Pregnancy

Abstract

Preliminary studies have demonstrated that salpingocentesis is a safe and effective treatment for unruptured ectopic pregnancies that are visible by transvaginal ultrasound. So far, experience with this technique has been confined to only a few centers around the world. The most promising results of these studies has been the virtual absence of side effects associated with local injection of either methotrexate or hyperosmolar glucose. Large prospective trials comparing efficacy, safety, and overall cost of salpingocentesis against systemic methotrexate will be necessary to better define the role of salpingocentesis in the management of ectopic pregnancy. Patient recruitment for this type of clinical trial would be feasible and acceptable to patients because both treatment arms would avoid surgery.

Local Treatment of Ectopic Pregnancy

“…Drawing from oocyte retrieval data, complications of salpingocentesis are rare but include bleeding, infection, and tubal damage, with potential for impairment of fertility. 52 Natofsky et al 52 reviewed the literature and found that adnexal masses were visualized transvaginally in 87 to 100% of ectopics. Brown analyzed TVUS procedures in 380 patients with surgically confirmed tubal pregnancies.…”

Minimally Invasive and Noninvasive Diagnosis and Therapy in Critically Ill and Injured Patients

“…102 Unruptured ectopic pregnancies can be now treated with ultrasound-guided percutaneous drainage. 103 Improvements in resolution have allowed many vascular surgical procedures to be performed with preoperative ultrasound instead of the more invasive arteriography. 104 In the ICU, portable ultrasound machines assist in the diagnosis and therapy of a variety of conditions, including blood flow studies for portal hypertension, deep venous thrombosis, or acalculous cholecystitis.…”

Protective effect of calcium folinate against methotrexate-induced endosalpinx damage in rats

“…Methotrexate (MTX) is a classical folate antagonist that has been used in the treatment of ectopic pregnancy (EP) for many years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Patients with EP can be successfully treated with MTX in various protocols and approaches (1)(2)(3)(5)(6)(7)(8)(9)(10).…”

“…Patients with EP can be successfully treated with MTX in various protocols and approaches (1)(2)(3)(5)(6)(7)(8)(9)(10). However, laboratory evidence suggests that MTX can induce toxicity in the endosalpinx (17)(18)(19).…”

“…Antifolate substances, represented by MTX, continue to occupy a unique and important niche among modern pharmacopoeia for patients with EP (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). MTX can inhibit normal trophoblasts and decrease cytotrophoblast differentiation and proliferation (4,30), and it can be used to treat EP effectively (1-3, 5-10).…”