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Successful conservative treatment for advanced interstitial pregnancy. A case report
Cheng-Li Chen1, Peng-Hui Wang, Lung-Mao Chiu
1Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
Background:
Interstitial pregnancy is a relatively rare and life-threatening disease, occurring in 2-4% of all extrauterine pregnancies, and the maternal mortality rate is 2-2.5%. Laparoscopic surgery and, less commonly, methotrexate are the treatments of choice for interstitial pregnancy. However, there is another treatment, ultrasound-guided direct injection of etoposide, the effect and safety of which are unclear.
Case Report:
In a 32-year-old woman with interstitial pregnancy at 12 weeks of gestation, ultrasound-guided direct injection of etoposide (100 mg) was used successfully after intravenous high-dose methotrexate, 300 mg (200 mg/m2), therapy failed to produce a response. The patient's posttherapeutic course was smooth. Twelve months after treatment, she conceived and later delivered a healthy infant vaginally without adverse events.
Conclusion:
Ultrasound-guided direct injection of etoposide offers another choice for treating advanced interstitial pregnancy, but further study is needed to define its efficacy and safety.