Petroulakis Athanasios, Tiong Bing Bing
Obstetrics and Gynaecology, Nottingham University Hospitals NHS Trust, Nottingham, GBR.
Cureus. 2024 Dec 16;16(12):e75783. doi: 10.7759/cureus.75783. eCollection 2024 Dec.
Ectopic pregnancy is a severe complication of early pregnancy that can lead to significant morbidity and mortality. Methotrexate is a standard non-surgical treatment for ectopic pregnancy, especially in cases where beta-human chorionic gonadotropin (β-HCG) levels are low. However, its effectiveness decreases as β-HCG levels rise. We present a case of a 38-year-old nulliparous woman with a high-β-HCG level ectopic pregnancy, who was managed successfully with methotrexate despite initial concerns about potential treatment failure. This case underscores the importance of patient-centered care, thorough counseling, and a multidisciplinary approach in managing complex ectopic pregnancies, particularly when standard guidelines may not fully apply. The patient was closely monitored and achieved a successful outcome without the need for surgery.
异位妊娠是早期妊娠的一种严重并发症，可导致显著的发病率和死亡率。甲氨蝶呤是异位妊娠的标准非手术治疗方法，特别是在β-人绒毛膜促性腺激素（β-HCG）水平较低的情况下。然而，随着β-HCG水平升高，其有效性会降低。我们报告一例38岁未生育女性，其异位妊娠β-HCG水平较高，尽管最初担心潜在的治疗失败，但经甲氨蝶呤治疗成功。该病例强调了以患者为中心的护理、全面咨询以及多学科方法在处理复杂异位妊娠中的重要性，尤其是在标准指南可能不完全适用的情况下。对该患者进行了密切监测，无需手术即取得了成功的治疗结果。
