AI Article Synopsis
- Interstitial (cornual) pregnancy is rare and can be life-threatening, requiring treatment options like methotrexate (MTX) or surgery if initial treatments fail.
- A 30-year-old woman successfully managed her 10-week interstitial pregnancy with a local ultrasound-guided 100-mg MTX injection after 3 doses of intramuscular MTX were ineffective.
- The local MTX injection resulted in a return to regular menstruation, undetectable hormone levels, and disappearance of the residual mass, suggesting it may be a preferred approach over systemic treatment in preserving uterine health.
Article Abstract
Background: Interstitial (cornual) pregnancy is a rare and life-threatening disease. Although systemic treatment with methotrexate (MTX) in an unruptured interstitial pregnancy has been used to preserve the entirety of the uterus, surgery is often used as a rescue method in failed cases. Use of an ultrasound-guided local injection can be a good alternative to surgery.
Case: A 30-year-old woman, gravida 1, para 0, with an interstitial pregnancy at 10 weeks of gestation, was successfully treated with an ultrasound-guided 100-mg MTX injection after a failed response to 3-dose intramuscular 100-mg MTX treatment (300 mg in total). Regular menstruation occurred 1 month after the local MTX injection. The serum beta-human chorionic gonadotropin level was undetectable 49 days later, and the residual mass had disappeared 6 months later,
Conclusion: Local injection of MTX may be a good means of managing an unruptured interstitial pregnancy to preserve the entirety of the uterus after failed systemic MTX treatment. Use of a local MTX injection may be a better choice than that of systemic MTX treatment.
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