A case of a methotrexate-resistant ectopic pregnancy in which dactinomycin was effective as a second-line chemotherapy

Fujioka, Satoe; Yamashita, Yoshiki; Kawabe, Sachiko; Kamegai, Hideki; Ohmichi, Masahide

doi:10.1016/j.fertnstert.2008.10.003

Cited by 9 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…High-risk factors for heterotopic pregnancy (HP) include a history of unilateral or bilateral salpingectomy [ 11 , 13 , 16 , 18 , 23 , 24 , 28 , 29 , 30 ], EP [ 11 , 16 , 18 , 24 , 28 , 29 ], ovulation induction, and IVF-ET [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Particularly, IVF-ET increases the occurrence of IP [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…The successful delivery rate of IUP after interventional ultrasound can reach 100% [ 6 ]. Available drugs are KCl [ 7 , 8 , 14 , 21 ] MTX [ 15 , 18 , 29 ] and hypertonic glucose [ 20 ]. Since the first report of the successful treatment of HIP by the ultrasound-guided injection of KCl in 1992 [ 7 ], many medical centers have carried out studies, all of which have achieved good results.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Tan

Chen

et al. 2023

JPM

View full text Add to dashboard Cite

Purpose: This study aims to share the experience of minimally invasive ultrasound-guided methotrexate intervention in the treatment of heterotopic interstitial pregnancy (HIP) with good pregnancy outcomes, and to review the treatment, pregnancy outcomes, and impact on the future fertility of HIP patients. Methods: The paper describes the medical history, clinical manifestations, treatment history, and clinical prognosis of a 31-year-old woman with HIP, and reviews cases of HIP from 1992 to 2021 published in the PubMed database. Results: The patient was diagnosed with HIP by transvaginal ultrasound (TVUS) at 8 weeks after assisted reproductive technology. The interstitial gestational sac was inactivated by ultrasound-guided methotrexate injection. The intrauterine pregnancy was successfully delivered at 38 weeks of gestation. Twenty-five HIP cases in 24 studies published on PubMed from 1992 to 2021 were reviewed. Combined with our case, there were 26 cases in total. According to these studies, 84.6% (22/26) of these cases were conceived by in vitro fertilization embryo transfer, 57.7% (15/26) had tubal disorders, and 23.1% (6/26) had a history of ectopic pregnancy; 53.8% (14/26) of the patients presented with abdominal pain and 19.2% (5/26) had vaginal bleeding. All cases were confirmed by TVUS. In total, 76.9% (20/26) of intrauterine pregnancies had a good prognosis (surgery vs. ultrasound interventional therapy 1:1). All fetuses were born without abnormalities. Conclusions: The diagnosis and treatment of HIP remain challenging. Diagnosis mainly relies on TVUS. Interventional ultrasound therapy and surgery are equally safe and effective. Early treatment of concomitant heterotopic pregnancy is associated with high survival of the intrauterine pregnancy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Tan

Chen

et al. 2023

JPM

View full text Add to dashboard Cite

show abstract

“…Our literature search for studies describing the medical management of interstitial ectopic pregnancies between 1999 and 2012 (Table ) confirmed that no other published series involved the technique that we used. Previous reports showed that conservative management with systemic MTX, transvaginal MTX injected under US guidance, or hysteroscopic guidance, or combined systemic and local MTX therapy are effective and safe options.…”

Section: Discussionmentioning

confidence: 99%

Transabdominal ultrasound‐guided injection of methotrexate in the treatment of ectopic interstitial pregnancies

Framarino-dei-Malatesta

Piccioni

Derme

et al. 2014

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

“…[5][6][7][8] Although it is uncertain if ART is a factor, reasons offered for an increase in heterotopic pregnancy include ovulation-inducing protocols that may result in more than one ovulated oocyte and alterations in tubal transport mechanism possibly affected by absolute and relative concentrations of estrogen and progesterone levels. 16,17 There is an association of highest rates of heterotopic pregnancy when more than five embryos have been transferred to the uterus. 7 Other predisposing risks may include tubal damage with history of pelvic inflammatory disease, postinfection scarring of tubal pregnancies, tubal sterilization procedure history, or infertility.…”

Section: Discussionmentioning

confidence: 99%

3D Volume Assessment of a Cornual Heterotopic Double Anembryonic Gestation and Response to Methotrexate Treatment

Hall

Byrn

Philippides

2012

Journal of Diagnostic Medical Sonography

View full text Add to dashboard Cite

show abstract

A case of a methotrexate-resistant ectopic pregnancy in which dactinomycin was effective as a second-line chemotherapy

Cited by 9 publications

References 10 publications

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Transabdominal ultrasound‐guided injection of methotrexate in the treatment of ectopic interstitial pregnancies

3D Volume Assessment of a Cornual Heterotopic Double Anembryonic Gestation and Response to Methotrexate Treatment

Contact Info

Product

Resources

About