Groutz A, Wolf Y, Caspi B, Wolman I, Gordon D, David M P
Department of Obstetrics and Gynecology, LisSerlin Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
J Reprod Med. 1998 Aug;43(8):719-22.
Data concerning medical treatment of interstitial ectopic pregnancies are scarce. These pregnancies are characterized by late and serious clinical manifestations. We report a case of advanced interstitial pregnancy treated successfully by combining methotrexate (MTX) and hysteroscopy.
A routine ultrasonic evaluation of a 10-week pregnancy revealed a right interstitial gestational sac 58 mm in diameter and containing an embryo with a crownrump length of 29 mm and embryonic heartbeats. Serum beta-human chorionic gonadatropin (hCG) level was 97,950 mIU/mL. The patient was treated with a systemic MTX/leucovorin regimen. At the end of the one-week course, no embryonic cardiac activity was detected, and a decrease in beta-hCG levels commenced. Persistent trophoblastic tissue, manifested by a low (26 mIU/mL) beta-hCG level in plateau, was successfully removed by way of hysteroscopy.
Early detection of interstitial pregnancy may facilitate conservative medical treatment.
关于间质部异位妊娠的医学治疗数据稀少。这些妊娠的特点是临床表现出现较晚且严重。我们报告一例通过甲氨蝶呤（MTX）与宫腔镜联合治疗成功的晚期间质部妊娠病例。
对一名妊娠10周的孕妇进行常规超声检查时，发现一个直径58毫米的右侧间质部妊娠囊，囊内有一个头臀长29毫米且有胎心搏动的胚胎。血清β-人绒毛膜促性腺激素（hCG）水平为97,950 mIU/mL。患者接受了全身MTX/亚叶酸钙治疗方案。在为期一周的疗程结束时，未检测到胚胎心脏活动，β-hCG水平开始下降。持续存在的滋养层组织表现为β-hCG水平处于低平台期（26 mIU/mL），通过宫腔镜成功清除。
间质部妊娠的早期检测可能有助于保守性医学治疗。
