Conservative Management of Retroperitoneal Ectopic Pregnancy by Computed Tomographic–guided Methotrexate Injection in the Gestational Sac: 2 Case Reports and Literature Review

Publication date: Available online 4 January 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Xiaohui Huang, Rui Zhong, Xiaochang Tan, Liqin Zeng, Kuiming Jiang, Shiwei Mei, Zhiqiu Ye, Xiping LuoABSTRACTRetroperitoneal ectopic pregnancy (REP) is an extremely rare type of ectopic pregnancy. Currently, surgery is the most widely used treatment method although it involves a high likelihood of intraoperative hemorrhage. In this case report, we describe a safe and effective alternative method for managing epigastric REP. We conducted a retrospective analysis of the clinical data of 2 patients with REP in the epigastrium who were treated at our hospital using our nonsurgical method. The treatment involved conservative management by computed tomographic–guided methotrexate injection in the gestational sac. We also present a literature review of 26 case reports and discuss the clinical features and various methods for treating REP. Our experience with the successful treatment of 2 patients suggests that the novel approach of computed tomographic–guided methotrexate injection in the gestational sac may be a safe and effective approach to manage REP. Further studies are warranted to confirm our findings.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research