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Article: Successful Treatment of a Pararenal Pregnancy Using High-Dose Methotrexate Regimen: A Case Report
Title | Successful Treatment of a Pararenal Pregnancy Using High-Dose Methotrexate Regimen: A Case Report |
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Authors | |
Keywords | Abdominal pregnancy Aorta Ectopic pregnancy Gestational trophoblastic neoplasia Hemoperitoneum |
Issue Date | 2016 |
Publisher | Journal 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? |
Abstract | BACKGROUND: 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 Identifier | http://hdl.handle.net/10722/220139 |
ISSN | 2022 Impact Factor: 0.2 2023 SCImago Journal Rankings: 0.103 |
DC Field | Value | Language |
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dc.contributor.author | Tse, KY | - |
dc.contributor.author | Cheung, VYT | - |
dc.contributor.author | Lam, C | - |
dc.contributor.author | Lee, EYP | - |
dc.contributor.author | Khong, PL | - |
dc.contributor.author | Ngan, HYS | - |
dc.date.accessioned | 2015-10-16T06:30:06Z | - |
dc.date.available | 2015-10-16T06:30:06Z | - |
dc.date.issued | 2016 | - |
dc.identifier.citation | Journal of Reproductive Medicine: for the obstetrician and gynecologist, 2016, v. 61 n. 6, p. 592-594 | - |
dc.identifier.issn | 0024-7758 | - |
dc.identifier.uri | http://hdl.handle.net/10722/220139 | - |
dc.description.abstract | BACKGROUND: 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.language | eng | - |
dc.publisher | Journal of Reproductive Medicine, Inc. The Journal's web site is located at http://www.reproductivemedicine.com | - |
dc.relation.ispartof | Journal of Reproductive Medicine: for the obstetrician and gynecologist | - |
dc.subject | Abdominal pregnancy | - |
dc.subject | Aorta | - |
dc.subject | Ectopic pregnancy | - |
dc.subject | Gestational trophoblastic neoplasia | - |
dc.subject | Hemoperitoneum | - |
dc.title | Successful Treatment of a Pararenal Pregnancy Using High-Dose Methotrexate Regimen: A Case Report | - |
dc.type | Article | - |
dc.identifier.email | Tse, KY: tseky@hkucc.hku.hk | - |
dc.identifier.email | Cheung, VYT: vytc@hku.hk | - |
dc.identifier.email | Lee, EYP: eyplee77@hku.hk | - |
dc.identifier.email | Khong, PL: plkhong@hku.hk | - |
dc.identifier.email | Ngan, HYS: hysngan@hkucc.hku.hk | - |
dc.identifier.authority | Cheung, VYT=rp01323 | - |
dc.identifier.authority | Lee, EYP=rp01456 | - |
dc.identifier.authority | Khong, PL=rp00467 | - |
dc.identifier.authority | Ngan, HYS=rp00346 | - |
dc.identifier.scopus | eid_2-s2.0-85002790379 | - |
dc.identifier.hkuros | 255261 | - |
dc.identifier.hkuros | 278811 | - |
dc.identifier.volume | 61 | - |
dc.identifier.issue | 6 | - |
dc.identifier.spage | 592 | - |
dc.identifier.epage | 594 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0024-7758 | - |