Yüce M A, Gücer F, Balkanli-Kaplan P, Sayin N C
Department of Obstetrics and Gynecology, Faculty of Medicine, Trakya University, Edirne (Turkey).
Clin Exp Obstet Gynecol. 2004;31(3):242-3.
We report the successful treatment of an unruptured ectopic pregnancy in a patient with extremely high beta-human chorionic gonadotropin concentrations. A 33-year-old woman, gravida 2, para 0, abortus 1, presented to our department due to menstrual delay. On transvaginal ultrasonography, she had an unruptured ectopic pregnancy (3.5 x 4.5 cm). Her initial beta-HCG concentration was 38,270 mIU/ml. The administration of methotrexate (50 mg/m2) was performed intramuscularly. Serum beta-HCG levels decreased > 15% between post-therapy days 4 (31,324 mIU/ml) and 7 (13,108 mIU/ml), and did not rise during the subsequent weekly controls. In selected cases with unruptured ectopic pregnancy and extremely high initial beta-HCG levels, medical management with a single-dose methotrexate regimen may be successful.
我们报告了一例β-人绒毛膜促性腺激素浓度极高的未破裂异位妊娠患者的成功治疗案例。一名33岁女性，孕2产0，流产1次，因月经推迟前来我院就诊。经阴道超声检查发现她患有未破裂异位妊娠（3.5×4.5厘米）。她最初的β-HCG浓度为38,270 mIU/ml。肌肉注射甲氨蝶呤（50 mg/m²）进行治疗。治疗后第4天（31,324 mIU/ml）至第7天（13,108 mIU/ml）血清β-HCG水平下降超过15%，且在随后的每周检查中未升高。在某些未破裂异位妊娠且初始β-HCG水平极高的病例中，单剂量甲氨蝶呤方案的药物治疗可能会成功。
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