An Early Abdominal Wall Ectopic Pregnancy Successfully Treated with Ultrasound Guided Intralesional Methotrexate: A Case Report

Abstract

Background. The upper anterior abdominal wall is a very unusual location for an ectopic pregnancy making optimal management uncertain. Case. We report the case of a 26-year-old gravida 4, para 1, aborta 2 with a rising quantitative human chorionic gonadotropin level following a negative diagnostic laparoscopic examination. She was subsequently diagnosed with an abdominal wall ectopic pregnancy 2 cm inferior to the liver. A single percutaneous intralesional injection of methotrexate was successful after initial failure with systemic methotrexate. Conclusion. Systemic methotrexate is a logical first choice for management of a stable early abdominal wall pregnancy. Direct intralesional injection of methotrexate as the next treatment choice may avoid the morbidity linked with operative management.

Secondary abdominal pregnancy with foetal mummification diagnosed using computed tomography in a dog: a case report

“…In humans, diagnosis of ectopic pregnancy includes analysis of serum β-human chorionic gonadotropin and progesterone levels, ultrasonography, diagnostic laparoscopy, and endometrial biopsy, among others (Corpa 2006;Sivalingam et al 2011). Although ultrasonography is the most preferred method in the diagnosis of ectopic pregnancy, CT or magnetic resonance imaging (MRI) can also provide sufficient evidence to make a diagnosis if clinical prediction has not been confirmed (Anderson et al 2009;Kao et al 2014). CT and MRI methods allow more accurate and rapid diagnosis by dint of sectional imaging (Febronio et al 2012;Kao et al 2014).…”

Successfully Treated Abdominal Pregnancy Causing Hemoperitoneum Using Combined Surgical and Systemic Methotrexate Therapy: A Case Report and Review of Cases Treated at Kyushu University Hospital

“…Known risk factors for abdominal pregnancy include history of infertility, previous pelvic infection, congenital anomaly, endometriosis, and ectopic pregnancy [3]. Because it can be associated with high maternal morbidity and mortality [2,3,4,16], such a pregnancy should be terminated as soon as possible following diagnosis [8]. …”

Primary abdominal pregnancy: A case report

“…Bu kriterleri tamamlayan olgular primer abdominal gebelik olarak tanımlanır. [3,6] Kliniğimize başvuran gebenin βHcg değerinin ilk etapta düzenli yükselmesi ve abdominal ağrının olmaması nedeniyle izlem kararı alınmış, daha sonra βHcg değe-ri yeterli artışı göstermediğinden probe küretaj yapıl-mıştır. Kesin abdominal gebelik tanısı laparoskopi bulgularına göre konulmuş ve mesane üzerindeki lezyonun varlığı ile uterus, tuba ve overlerin normal görül-mesi üzerine Studdiford kriterlerine göre primer abdominal gebelik olduğu düşünülmüştür.…”

“…[3,10] Lokal tedavi yeterli olmadığında sistemik metotreksat tedavisi veya cerrahi uygulanabilir. Biz olgumuzda ilk etapta sistemik metotreksat uygulamayı düşünsek de, hastada akut batın bulgularının gelişmesi nedeniyle cerrahi kararı verilmiştir.…”

“…[1] Dış gebeliklerin %95'i tubal, %3.2'si ovaryan, %1.3'ü ise abdominal yerleşimlidir. [2][3][4] Abdominal gebeliklerde gestasyonel kese genellikle pelvise veya karaciğer ve mezenter gibi yüksek vasküler bölgele-re implante olur. [4] Maternal morbidite ve mortalitenin önemli nedenlerindendir.…”