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Article: Successful Treatment of a Pararenal Pregnancy Using High-Dose Methotrexate Regimen: A Case Report

TitleSuccessful Treatment of a Pararenal Pregnancy Using High-Dose Methotrexate Regimen: A Case Report
Authors
KeywordsAbdominal pregnancy
Aorta
Ectopic pregnancy
Gestational trophoblastic neoplasia
Hemoperitoneum
Issue Date2016
PublisherJournal of Reproductive Medicine, Inc. The Journal's web site is located at http://www.reproductivemedicine.com
Citation
Journal of Reproductive Medicine: for the obstetrician and gynecologist, 2016, v. 61 n. 6, p. 592-594 How to Cite?
AbstractBACKGROUND: Upper abdominal pregnancy is rare. Most patients present with hemoperitoneum, requiring emergency laparotomy. CASE: A 32-year-old woman presented with acute abdominal pain and an elevated beta–human chorionic gonadotropin (β-hCG) level. Ultrasound, computerized tomography (CT) scans, and laparoscopy failed to locate the source of elevated hCG. Subsequent positron emission tomography (PET)–CT demonstrated a cystic mass in the left pararenal region with no increased uptake. Repeated ultrasound scan revealed a live fetus implanted laterally to the abdominal aorta. After failing to respond to methotrexate at the usual dosage, a regimen used in gestational trophoblastic neoplasia was given. The pregnancy underwent miscarriage afterwards, and the hCG level gradually returned to normal. CONCLUSION: The site of an ectopic pregnancy should be sought thoroughly to avoid missing an abdominal pregnancy and hence disastrous hemoperitoneum. While medical therapy with high-dose methotrexate is not a standard treatment, it can be considered after failing the traditional therapy, provided that there is adequate treatment monitoring and expertise in handling the side effects of the medication.
Persistent Identifierhttp://hdl.handle.net/10722/220139
ISSN
2015 Impact Factor: 0.84
2015 SCImago Journal Rankings: 0.388

 

DC FieldValueLanguage
dc.contributor.authorTse, KY-
dc.contributor.authorCheung, VYT-
dc.contributor.authorLam, C-
dc.contributor.authorLee, EYP-
dc.contributor.authorKhong, PL-
dc.contributor.authorNgan, HYS-
dc.date.accessioned2015-10-16T06:30:06Z-
dc.date.available2015-10-16T06:30:06Z-
dc.date.issued2016-
dc.identifier.citationJournal of Reproductive Medicine: for the obstetrician and gynecologist, 2016, v. 61 n. 6, p. 592-594-
dc.identifier.issn0024-7758-
dc.identifier.urihttp://hdl.handle.net/10722/220139-
dc.description.abstractBACKGROUND: Upper abdominal pregnancy is rare. Most patients present with hemoperitoneum, requiring emergency laparotomy. CASE: A 32-year-old woman presented with acute abdominal pain and an elevated beta–human chorionic gonadotropin (β-hCG) level. Ultrasound, computerized tomography (CT) scans, and laparoscopy failed to locate the source of elevated hCG. Subsequent positron emission tomography (PET)–CT demonstrated a cystic mass in the left pararenal region with no increased uptake. Repeated ultrasound scan revealed a live fetus implanted laterally to the abdominal aorta. After failing to respond to methotrexate at the usual dosage, a regimen used in gestational trophoblastic neoplasia was given. The pregnancy underwent miscarriage afterwards, and the hCG level gradually returned to normal. CONCLUSION: The site of an ectopic pregnancy should be sought thoroughly to avoid missing an abdominal pregnancy and hence disastrous hemoperitoneum. While medical therapy with high-dose methotrexate is not a standard treatment, it can be considered after failing the traditional therapy, provided that there is adequate treatment monitoring and expertise in handling the side effects of the medication.-
dc.languageeng-
dc.publisherJournal of Reproductive Medicine, Inc. The Journal's web site is located at http://www.reproductivemedicine.com-
dc.relation.ispartofJournal of Reproductive Medicine: for the obstetrician and gynecologist-
dc.subjectAbdominal pregnancy-
dc.subjectAorta-
dc.subjectEctopic pregnancy-
dc.subjectGestational trophoblastic neoplasia-
dc.subjectHemoperitoneum-
dc.titleSuccessful Treatment of a Pararenal Pregnancy Using High-Dose Methotrexate Regimen: A Case Report-
dc.typeArticle-
dc.identifier.emailTse, KY: tseky@hkucc.hku.hk-
dc.identifier.emailCheung, VYT: vytc@hku.hk-
dc.identifier.emailLee, EYP: eyplee77@hku.hk-
dc.identifier.emailKhong, PL: plkhong@hku.hk-
dc.identifier.emailNgan, HYS: hysngan@hkucc.hku.hk-
dc.identifier.authorityCheung, VYT=rp01323-
dc.identifier.authorityLee, EYP=rp01456-
dc.identifier.authorityKhong, PL=rp00467-
dc.identifier.authorityNgan, HYS=rp00346-
dc.identifier.hkuros255261-
dc.identifier.volume61-
dc.identifier.issue6-
dc.identifier.spage592-
dc.identifier.epage594-
dc.publisher.placeUnited States-

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