Mustafa Gazi UÇAR, Senem TUNÇ YAMAN, Neval GÖRÜK YAMAN, Özlem TOSUN, Ahmet GÖÇMEN

Treatment of cornual viable pregnancy with single dose methotrexate: Case report

Cerrahi müdahaleye gerek kalmadan tek doz metotreksat ile başarılı bir şekilde tedavi ettiğimiz kornual canlı gebeliği olan bir olguyu sunmaktayız. Ultrason bulguları ve horman ölçümleri ile kornual gebelik tanısını koyduğumuz 37 yaşındaki olgumuza tek doz sistemik metotreksat (50 mg/ m2) tedavisi uyguladık. Hiç bir yan ekti gözlenmedi. İnterstisyel gebelikte erken tanı konservatif tedavi seçeneklerine imkân sağlar. Her ne kadar konservatif tedavide en etkili metotreksat protokolü belirlenmiş olmasa da hemodinamik olarak stabil olgularda tek doz sistemik metotreksat tedavisinin etkin olduğu söylenebilir ve ilk tedavi seçeneği olarak göz önünde bulundurulabilir. Canlı gebelik veya yüksek düzeyde human koryonik gonadotropin (B-hCG) tespit edilmiş olsa da bu tedavi güvenli ve oldukça efektif bir yöntemdir. En önemli kriter hemodinamik stabilitedir ve bu da doğrudan erken tanı ile ilişkilidir. Cerrahiden kaçınılabilir ancak konservatif tedavilerde daha uzun ve yakın takip gereklidir.

Tek doz metotreksat ile tedavi edilen canlı kornual gebelik: Olgu Sunumu

We herein report a case of cornual viable pregnancy that was successfully treated with a single dose methotrexate without the need for surgical intervention. A 37 yearold woman was diagnosed cornual pregnancy based on transvaginal ultrasound findings and hormonal assays. A single dose systemic methotrexate (50 mg/m2) was administered. No side effects were experienced. Early diagnosis of interstitial pregnancy can lead to conservative treatment options. Although the most effective methotrexate protocol for conservative treatment is uncertain we concluded that in the hemodynamically stable patient a single dose systemic methotrexate treatment is a useful and should be considered as the first line treatment. This is safe and highly effective management even though viable fetus or high level of human chorionic gonadotropin (B-hCG) was assigned. Hemodynamic stability is the most important criteria and that is directly correlated with the early diagnosis. Surgery can be avoided; however, with conservative management a longer and close followup is required.

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