Successful Management of Cervical and Tubal Stump Double Pregnancy after Assisted Reproductive Technologies Using Multiple High Doses of Methotrexate: A Case Report
Gaiday A. Tussupkaliyev A. Nurken A. Gaiday A. Primbetova A. Dossimbetova M. Yeszhanova A. Karimsakova B. Ablakimova N.
July 2024Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
2024#49Issue 7461 - 466 pp.
The incidence of ectopic pregnancy (EP) has increased in recent years, owing to causes such as pelvic inflammatory diseases and assisted reproductive technologies (ART). The present study reported a case of a 33-year-old nulliparous woman with a history of previous ectopic pregnancies, who underwent pelvic ultrasound in August 2022, which revealed a double EP including a cervical pregnancy and a tubal stump pregnancy. Despite known risk factors and elevated beta-human chorionic gonadotropin (β-hCG) levels, a conservative approach, utilizing multiple doses of systemic methotrexate (MTX) injections, was employed to preserve fertility at the Regional Perinatal Center in Aktobe, Kazakhstan. Treatment efficacy was monitored through β-hCG levels and ultrasound imaging, with successful resolution of both EPs and preservation of reproductive function. The present case highlighted the safety and efficacy of MTX therapy in managing complex EP presentations, emphasizing the necessity of individualized treatment approaches in reproductive medicine, particularly in terms of preserving fertility in patients undergoing ART. Multiple high doses of MTX injections were beneficial for pregnancy with two distinct regions, fetal cardiac activity, and elevated serum β-hCG level. Further research is required to explore optimal treatment strategies for EP, considering patient-specific factors and treatment goals.
Methotrexate , Pregnancy, ectopic , Reproductive techniques, assisted
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Department of Obstetrics and Gynecology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Gynecology, Regional Perinatal Center, Aktobe, Kazakhstan
Department of General Medical Practice, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Hospital Pharmacy, Regional Perinatal Center, Aktobe, Kazakhstan
Department of Obstetrics and Gynecology
Department of Gynecology
Department of General Medical Practice
Department of Pharmacology
Department of Hospital Pharmacy
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