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Human Reproduction, Vol 13, 1981-1986, Copyright © 1998 by Oxford University Press

REVIEWS

Medical management of interstitial ectopic pregnancy: a case report and literature review

JD Fisch, BH Ortiz, SI Tazuke, U Chitkara and LC Giudice
Division of Reproductive Endocrinology and Infertility, Stanford University School of Medicine, California 94305, USA.

Recent reports describe successful treatment of interstitial ectopic pregnancies using methotrexate. While the number of reported cases is increasing, no consensus exists regarding the management of this complication of pregnancy. We present the successful use of combined systemic and direct intrasac injection of methotrexate for an interstitial pregnancy with the highest yet reported initial beta-human chorionic gonadotrophin concentration (102,000 mIU/ml). We also describe the use of Doppler ultrasound for monitoring treatment progression. Through a review of the current literature, we propose to facilitate management decisions and increase outcome success by summarizing previously reported treatment regimens and by describing enhanced parameters for patient selection and monitoring.
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