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Ginecología y obstetricia de México
versión impresa ISSN 0300-9041
Resumen
MIRANDA-FLORES, Alan Francis y RISCO-NEYRA, Roxana. Management of uncomplicated ectopic pregnancy with local injection of methotrexate. Ginecol. obstet. Méx. [online]. 2022, vol.90, n.9, pp.726-734. Epub 20-Ene-2023. ISSN 0300-9041. https://doi.org/10.24245/gom.v90i9.7838.
OBJECTIVE:
To describe the experience in the care of patients with uncomplicated ectopic pregnancy with ultrasound-guided local injection of methotrexate.
MATERIALS AND METHODS:
Retrospective, descriptive, case series study conducted from January 1, 2021 to February 28, 2022 at the Instituto Nacional Materno Perinatal, Lima, Peru. Participants had uncomplicated ectopic pregnancy treated with ultrasound-guided local injection of methotrexate. Data were obtained from medical records. Statistical analysis was processed in SPSS 19.
RESULTS:
11 ultrasound-guided local methotrexate injections were performed. According to their location 4 pregnancies were tubal, 1 cervical and 6 in cesarean scar. The average age of the pregnant women was 34.5 years. The average number of weeks of pregnancy was 7. The initial b-hCG concentration was 42812.55 mU/mL. The mean gestational sac size was 22.8 mm. The mean embryo size was 7.81 mm. Embryonic cardiac activity was detected in 10 cases that received an intrathoracic injection of potassium chloride until no heartbeat was evident. A single case received an additional systemic dose of methotrexate. Another case resulted in hemoperitoneum, due to rupture of ectopic pregnancy after local injection.
CONCLUSIONS:
Ultrasound-guided local injection of methotrexate is an alternative to other surgical techniques applied to treat patients with uncomplicated ectopic pregnancy with surgical indication.
Palabras llave : Ectopic pregnancy; Ultrasound-guided; Methotrexate; Gestational sac; Cicatrix, Pregnancy, ectopic.