Fisch J D, Ortiz B H, Tazuke S I, Chitkara U, Giudice L C
Division of Reproductive Endocrinology and Infertility, Stanford University School of Medicine, California 94305, USA.
Hum Reprod. 1998 Jul;13(7):1981-6. doi: 10.1093/humrep/13.7.1981.
Recent reports describe successful treatment of interstitial ectopic pregnancies using methotrexate. While the number of reported cases is increasing, no consensus exists regarding the management of this complication of pregnancy. We present the successful use of combined systemic and direct intrasac injection of methotrexate for an interstitial pregnancy with the highest yet reported initial beta-human chorionic gonadotrophin concentration (102,000 mIU/ml). We also describe the use of Doppler ultrasound for monitoring treatment progression. Through a review of the current literature, we propose to facilitate management decisions and increase outcome success by summarizing previously reported treatment regimens and by describing enhanced parameters for patient selection and monitoring.
近期报告描述了使用甲氨蝶呤成功治疗间质部异位妊娠的案例。虽然报告的病例数量在增加，但对于妊娠这一并发症的处理尚无共识。我们报告了成功联合全身及直接向孕囊内注射甲氨蝶呤治疗一例间质部妊娠的案例，该病例初始β-人绒毛膜促性腺激素浓度为迄今报告的最高值（102,000 mIU/ml）。我们还描述了使用多普勒超声监测治疗进展的情况。通过回顾当前文献，我们建议通过总结先前报告的治疗方案以及描述用于患者选择和监测的强化参数，来促进管理决策并提高治疗成功率。
