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Obstet Gynecol ; 122(2 Pt 2): 461-464, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23884260

ABSTRACT

BACKGROUND: Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. CASE: We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. CONCLUSION: Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.


Subject(s)
Abortifacient Agents, Nonsteroidal/administration & dosage , Methotrexate/administration & dosage , Pregnancy, Ectopic/drug therapy , Abortifacient Agents, Nonsteroidal/therapeutic use , Adult , Chorionic Gonadotropin/blood , Female , Humans , Methotrexate/therapeutic use , Potassium Chloride/therapeutic use , Potassium Compounds/therapeutic use , Pregnancy , Uterine Artery Embolization , Uterine Hemorrhage/etiology , Uterine Hemorrhage/therapy , Young Adult
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