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Horm Mol Biol Clin Investig ; 41(2)2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32167930

RESUMO

Intramyometrial ectopic pregnancy (IMEP) is a rare form of ectopic pregnancy. It is defined as a conceptus implanted within the myometrium and is completely surrounded by myometrium with clear separation from both the uterine cavity and tubes. IMEP possesses not only diagnostic but also therapeutic challenge. The majority of reported cases were managed by hysterectomy. Early management of unruptured IMEP using methotrexate may help to preserve fertility. We, for the first time, report a case of ruptured IMEP managed successfully using suction and curettage followed by Bakri balloon tamponade and avoiding hysterectomy. Post-procedure, the patient received two doses of intramuscular methotrexate 50 mg/m2 due to plateauing serial beta human chorionic gonadotropin (ß-hCG) levels and subsequently achieved undetectable level 10 weeks post-methotrexate. She also had complete resolution of the ectopic intramyometrial mass.


Assuntos
Miométrio , Tratamentos com Preservação do Órgão/métodos , Gravidez Ectópica/cirurgia , Tamponamento com Balão Uterino , Ruptura Uterina/terapia , Curetagem a Vácuo , Abortivos não Esteroides/uso terapêutico , Adulto , Gonadotropina Coriônica Humana Subunidade beta/sangue , Feminino , Humanos , Metotrexato/uso terapêutico , Miométrio/diagnóstico por imagem , Gravidez , Gravidez Ectópica/sangue , Gravidez Ectópica/diagnóstico por imagem , Ruptura Espontânea , Hemorragia Uterina/etiologia , Hemorragia Uterina/terapia , Ruptura Uterina/etiologia
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