Successful management of caesarean scar live ectopic pregnancies with local KCL and systemic methotrexate

BMJ Case Rep. 2017 Oct 24:2017:bcr2017221844. doi: 10.1136/bcr-2017-221844.

Abstract

Two cases of live caesarean scar ectopic pregnancies are presented. Beta human chorionic gonadotropin (b-hCG) values in both patients at presentation were 50 099 mIU and 297 969 mIU, respectively. Both were managed with intrasac potassium chloride injection to induce fetal demise and multiple dose methotrexate therapy. The time for b-hCG to become negative in both patients was 91 days and 119 days, respectively. Successful management of live caesarean scar pregnancies even with very high b-hCG is possible with minimally invasive approach.

Keywords: gynaecology and fertility; obstetrics; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Abortifacient Agents, Nonsteroidal / therapeutic use*
  • Adult
  • Cesarean Section*
  • Cicatrix / diagnostic imaging*
  • Female
  • Humans
  • Methotrexate / therapeutic use*
  • Potassium Chloride / therapeutic use*
  • Pregnancy
  • Pregnancy, Ectopic / diagnostic imaging
  • Pregnancy, Ectopic / drug therapy*
  • Ultrasonography / methods

Substances

  • Abortifacient Agents, Nonsteroidal
  • Potassium Chloride
  • Methotrexate