Multiple-dose methotrexate for pregnancy in a cesarean section scar. A case report.
J Reprod Med
; 47(4): 332-4, 2002 Apr.
Article
em En
| MEDLINE
| ID: mdl-12012889
ABSTRACT
BACKGROUND:
Pregnancy developing in a cesarean section scar is a very rare but possibly life-threatening condition because of the risk of rupture and excessive hemorrhage. CASE A woman with previous cesarean section had transvaginal sonography performed at 7 weeks of gestation that showed a gestational sac implanted in the anterior isthmus wall of the uterus with 3 mm of myometrium between the sac and bladder wall. A diagnosis of pregnancy in the cesarean section scar was made. The patient was asymptomatic, and her hemodynamic condition was stable. Two courses of multiple-dose systemic methotrexate-folinic acid (1 mg/kg methotrexate intramuscularly on days 1, 3, 5 and 7 with 0.1 mg/kg folinic acid intramuscularly on days 2, 4, 6 and 8) were given. The patient tolerated it and remained stable during treatment. The serum hCG dropped to < 5 IU/L on day 56.CONCLUSION:
Treatment with methotrexate is a non-surgical option that can improve preservation of the uterus in patients who desire fertility. A multiple-dose regimen causes rapid interruption of the pregnancy. This is very important because the risk of rupture and hemorrhage directly correlates with the duration of the pregnancy.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gravidez Ectópica
/
Abortivos não Esteroides
/
Cesárea
/
Metotrexato
/
Cicatriz
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
J Reprod Med
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
Hong Kong