'Chemical curettage' using intrauterine methotrexate injection.

A 22-year-old woman with multiple urogenital anomalies presented for the second time with a blighted ovum situated in the rudimentary right horn of a uterus communicans bicornis. A dilatation and curettage was not possible owing to the inaccessibility of this horn. The first blighted ovum was aborted in 1989 (at age 21 years) following the use of intramuscular prostaglandin therapy. On this occasion, therapy was by the transvaginal, intrauterine (intra-amniotic) instillation of 100 mg methotrexate and a complete abortion of the products of conception occurred. Similar to the treatment of ectopic pregnancy, in certain cases, termination of intrauterine pregnancies using local methotrexate injection may be considered.