SUCCESSFUL TREATMENT OF ADVANCED INTERSTITIAL PREGNANCY WITH METHOTREXATE AND HYSTEROSCOPY - A CASE-REPORT

BACKGROUND: Data concerning medical treatment of interstitial ectopic pregnancies are scarce. These pregnancies ave characterized by late an d serious clinical manifestations. We report a case of advanced inters titial pregnancy treated successfully by combining methotrexate (MTX) and hysteroscopy. CASE: A routine ultrasonic evaluation of a 10-week p regnancy revealed a right interstitial gestational sac 58 mm in diamet er and containing an embryo with a crown-rump length of 29 mm and embr yonic heartbeats. Serum beta-human chorionic gonadotropin (hCG) level was 97,950 mIU/mL. The patient wits treated with a systemic MTX/leucov orin regimen. At the end of the one-week course, no embryonic cardiac activity was detected, and a decrease in beta-hCG levels commenced. Pe rsistent trophoblastic tissue, manifested by a low (26 mIU/mL) beta-hC G level in plateau, was successfully removed by way of hysteroscopy. C ONCLUSION: Early detection of interstitial pregnancy may facilitate co nservative medical treatment.