Ozkan Zehra Sema, Kumbak Banu, Sapmaz Ekrem, Simsek Mehmet
Department of Obstetrics and Gynecology, Firat University School of Medicine, Elazig, Turkey.
Case Rep Obstet Gynecol. 2011;2011:619094. doi: 10.1155/2011/619094. Epub 2011 Jul 9.
Cornual pregnancy is a rare type of ectopic pregnancy, and diverse therapeutic options exist for the management. Medical treatment despite high initial beta HCG values is not thought to be safe. We reported a 39-year-old woman with an initial beta HCG value of 22000 mIU/mL and diagnosed of a cornual pregnancy. Patient was managed successfully with the administration of combined systemic and ultrasonographically guided local injection of methotrexate into the gestational sac. During followup with serial beta hcg measurements, 27 × 20 mm cystic area in myometrium has been detected. Beta hcg <1 mIU/mL value was reached three months later, and this cystic area resolved spontaneously. Systemic methotrexate administration combined with ultrasound-guided local methotrexate injection into the gestational sac might be considered as the first-line treatment in the management of hemodynamically stable patients having cornual pregnancy even with high beta HCG values and risk of myometrial cystic formation.
宫角妊娠是一种罕见的异位妊娠类型，针对其治疗存在多种选择。尽管初始β-HCG值较高，但药物治疗被认为不安全。我们报告了一名39岁女性，其初始β-HCG值为22000 mIU/mL，被诊断为宫角妊娠。该患者通过全身联合超声引导下向妊娠囊局部注射甲氨蝶呤成功得到治疗。在后续连续检测β-HCG的过程中，发现子宫肌层有一个27×20 mm的囊性区域。三个月后β-HCG值降至<1 mIU/mL，且该囊性区域自行消退。对于血流动力学稳定、即使β-HCG值高且有子宫肌层囊性形成风险的宫角妊娠患者，全身应用甲氨蝶呤联合超声引导下向妊娠囊局部注射甲氨蝶呤可被视为一线治疗方法。
