The successful conservative management of tubal pregnancy with poor prognosis through ultrasound-guided intraamnionic methotrexate injection: Two case reports.

Hwang, Sun Jung; Lee, Soo Jeong; Kim, Sul Ah; Choi, Jeong In; Shin, Jong Chul; Choi, Sae Kyung

doi:2012.55.11.848

Obstet Gynecol Sci > Volume 55(11); 2012 > Article

Case Report

Korean Journal of Obstetrics & Gynecology 2012;55(11):848-852.
DOI: https://doi.org/10.5468/KJOG.2012.55.11.848 Published online November 16, 2012.

The successful conservative management of tubal pregnancy with poor prognosis through ultrasound-guided intraamnionic methotrexate injection: Two case reports.

Sun Jung Hwang, Soo Jeong Lee, Sul Ah Kim, Jeong In Choi, Jong Chul Shin, Sae Kyung Choi

Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, Seoul, Korea. obgysk@catholic.ac.kr

Abstract

Ectopic pregnancy occurs in about 2% of pregnant women, and may seriously compromise women's health. Extra uterine implantation can occur anywhere along the reproductive tract with the most common implantation site in the fallopian tube. At early stages of presentation where the risk of rupture of a tubal pregnancy is minimal, medical therapy using methotrexate (MTX) given systemically or injected directly into the ectopic pregnancy is an option occasionally used with good results. In addition, ultrasound technology, particularly the introduction of high-resolution transvaginal probes, has been the driving force behind the revolutionary change towards conservative management strategies in ectopic pregnancy care. Tubal pregnancy can be successfully managed without surgical intervention through local injection of MTX. This treatment not only ablates the ectopic pregnancy but also preserves the salpinx without systemic side effect. In this report, we present two cases of tubal pregnancy which treated successfully with ultrasound-guided intraamnionic MTX injection.

Key Words: Ectopic pregnancy, Methotrexate, Interventional ultrasound