Fertility and sterility · 2009
A case of a methotrexate-resistant ectopic pregnancy in which dactinomycin was effective as a second-line chemotherapy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Fujioka Satoe, Yamashita Yoshiki, Kawabe Sachiko, Kamegai Hideki, Terai Yoshito, Ohmichi Masahide
Аннотация
OBJECTIVE: To report a case of a methotrexate (MTX)-resistant heterotopic interstitial pregnancy in which dactinomycin was necessary as a second-line chemotherapy.
DESIGN: Case report.
SETTING: Medical college-affiliated hospital.
PATIENT(S): A 39-year-old woman with vaginal bleeding after the transfer of two thawed 8-cell embryos.
INTERVENTION(S): MTX 50 mg/m(2) was given to the patient to treat a concomitant pregnancy in which an interstitial pregnancy and an intrauterine blighted ovum were identified. However, the patient's hCG level rose despite two MTX administrations. As a result, dactinomycin was then administered as a second-line chemotherapy. The patient's serum hCG level declined to a normal range after two administrations of dactinomycin.
CONCLUSION(S): Dactinomycin could be an alternative in cases for which MTX is not effective and persistently high hCG levels exist.
DESIGN: Case report.
SETTING: Medical college-affiliated hospital.
PATIENT(S): A 39-year-old woman with vaginal bleeding after the transfer of two thawed 8-cell embryos.
INTERVENTION(S): MTX 50 mg/m(2) was given to the patient to treat a concomitant pregnancy in which an interstitial pregnancy and an intrauterine blighted ovum were identified. However, the patient's hCG level rose despite two MTX administrations. As a result, dactinomycin was then administered as a second-line chemotherapy. The patient's serum hCG level declined to a normal range after two administrations of dactinomycin.
CONCLUSION(S): Dactinomycin could be an alternative in cases for which MTX is not effective and persistently high hCG levels exist.