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Methotrexate for Cornual Ectopic Pregnancy

Barbara M Parker, Anupam Gupta, Anastasios Lymperopoulos, John O. Parker

2020Cureus15 citationsDOIOpen Access PDF

Abstract

A 27-year-old pregnant female presented to the emergency department with pelvic pain and vaginal bleeding. At the time of diagnosis, she had an ectopic pregnancy in the right cornua 4 cm in size with a human chorionic gonadotropin (hCG) value of 14,438 international units per mL. The ectopic pregnancy was initially managed by intramuscular methotrexate. However, after 10 days, despite an hCG value drop to 409 international units per mL, an indication that methotrexate was working, the patient had a subsequent rupture with hemoperitoneum necessitating exploratory laparotomy and abdominal hysterectomy.

Topics & Concepts

MedicineEctopic pregnancyMethotrexateHemoperitoneumExploratory laparotomyVaginal bleedingLaparotomyHuman chorionic gonadotropinObstetricsAbdominal painAdnexal massPregnancySurgeryGynecologyInternal medicineHormoneGeneticsBiologyEctopic Pregnancy Diagnosis and ManagementGestational Trophoblastic Disease StudiesAppendicitis Diagnosis and Management