Successful Conservative Chemotherapy for Intramural Pregnancy: A Case Report.

Park, Eun Ah; Cho, Jun Sik; Lee, Dong Heon

Case Report

Korean Journal of Obstetrics & Gynecology 2003;46(12):2476-2481.
Published online December 1, 2003.

Successful Conservative Chemotherapy for Intramural Pregnancy: A Case Report.

Eun Ah Park, Jun Sik Cho, Dong Heon Lee

Department of Obstetrics and Gynecology, College of Medicine, Kangwon National University, Chunchon, Korea.

Abstract

More than 95% of ectopic pregnancies involve the fallopian tubes. Other sites of ectopic implantation are less frequent, and a pregnancy in the myometrium is extremely rare. Few cases are reported in the literature which satisfy the criteria required for the diagnosis of intramural ectopic pregnancy, and unequivocal diagnosis without extirpation of the ruptured uterus is difficult. Most of ruptured cases have been treated with surgical modality including hysterectomy, and for more conservative management early detection is important. MRI is a useful, noninvasive and confirmative imaging modality for the detection of intramural pregnancy. Chemotherapy with methotrexate is an effective treatment that allows preservation of reproductive potential in selected case. We described a case of unruptured intramural pregnancy diagnosed with MRI and successfully treated with methotrexate. Theoretical and possible pathophysiologic derangements of this rare pregnancy- related disorder are also reviewed.

Key Words: Intramural pregnancy, Magnetic resonance imaging, Methotrexate