AI Article Synopsis
- Intramyometrial pregnancies are rare, accounting for about 1% of all ectopic pregnancies, and often require surgical intervention.
- A 32-year-old woman was diagnosed with this condition at 6 weeks of pregnancy, confirmed through ultrasound and MRI, and was successfully treated with multidose methotrexate.
- The case highlights that multidose methotrexate can be considered a viable treatment option for stable patients with intramyometrial pregnancies when surgical access is limited.
Article Abstract
Background: An intramyometrial pregnancy is a rare form of ectopic pregnancy, making up an estimated 1% of all ectopic pregnancies. Previously described management options have included surgical excision in the emergency setting.
Case: A 32-year-old woman, gravida 4 para 0, at 6 0/7 weeks of gestation by last menstrual period, was noted to have a gestational sac implanted entirely within the uterine myometrium. Ultrasonography and magnetic resonance imaging confirmed the presence of an intramyometrial ectopic pregnancy within a septate uterus. The patient's abnormal pregnancy was successfully treated with multidose methotrexate.
Conclusion: Intramyometrial pregnancy is a rare entity that should be considered when it is suggested by ultrasonography or if an intrauterine pregnancy is surgically inaccessible from the endometrial cavity. In a stable patient, multidose systemic methotrexate may be a feasible management strategy.
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| http://dx.doi.org/10.1097/AOG.0000000000005312 | DOI Listing |
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