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Non‐surgical management of live ectopic pregnancy with ultrasound‐guided local injection: a case series
Author(s) -
Monteagudo A.,
Minior V. K.,
Stephenson C.,
Monda S.,
TimorTritsch I. E.
Publication year - 2005
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.1822
Subject(s) - medicine , ectopic pregnancy , gestational sac , methotrexate , ultrasound , obstetrics , local anaesthetic , gestational age , surgery , pregnancy , radiology , genetics , biology
Objectives To describe a series of consecutive cases of live ectopic pregnancies managed with ultrasound‐guided local injection of methotrexate (MTX) or potassium chloride (KCl). Methods Eighteen consecutive women with live and unruptured, tubal, cornual or cervical ectopic pregnancies referred to our unit for evaluation and management underwent risk–benefit counseling. Under transvaginal ultrasound guidance, puncture and injection of the ectopic pregnancy was performed using an automated puncture device. Either MTX or KCl was injected, producing immediate cessation of fetal cardiac activity. Results Of the 18 ectopic pregnancies, 10 were cervical, four were tubal and four were cornual. The mean initial β‐hCG level was 33 412 IU and the mean gestational age was 6 + 6 weeks. Ten ectopic gestational sacs were injected with KCl and eight were injected with MTX. There was no difference in time to resolution of the ectopic pregnancies between those injected with KCl and those with MTX. Conclusions Unruptured live ectopic pregnancies of many types can be successfully managed without surgical intervention through local injection of KCl or MTX. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.