Volume 6, Issue 2 (7-2008)                   IJRM 2008, 6(2): 45-0 | Back to browse issues page

XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Taheripanah R, Hosseini M S, Hashemi M. Tubal patency after ultrasound guided local injection of KCL to tubal ectopic pregnancy with alive fetus. IJRM. 2008; 6 (2) :45-0
URL: http://journals.ssu.ac.ir/ijrmnew/article-1-100-en.html
1- Obstetrics and Gynecology Dept, IRHRC Center, Shahid Beheshti University, Tehran, Iran , Taheripanahf@yahoo.com
2- Obstetrics and Gynecology Dept, Imam Hossein Hospital, Shahid Beheshti university (M.C),Tehran, Iran
3- Pathology Department, Shahid Beheshti University (M.C), Tehran, Iran
Abstract:   (491 Views)
Background: Ectopic pregnancy is one of the pathologic entities that it destroys the fallopian tube and impairs the future pregnancy. There are different medical and surgical therapies in order the treatment and reserve of fertility. The aim of this report is discuss a case of successful intrauterine after management of ectopic pregnancy with local injection of KCL in an infertile PCOD patient.
Case: The patient was a PCOD woman with gestational age of 8.5 weeks. One gestational sac and alive fetus with normal heart beat was seen in the right adnexa. Hemodynamic situation was stable. 0.5cc KCL 10% was injected to the fetal heart and the extracted tissue sent for pathology. We evaluated the effects of this treatment by measuring serial human chorionic gonadotropin (hCG) titers. Moreover, we used hysterosalpingogrphy to diagnose and to evaluate the patency of the tubes. Induction ovulation and intrauterine insemination was done and pregnancy occurred. Patient passed the pregnancy very good and she delivered by cesarean section due to breech presentation at 39 weeks of gestational age. There was no sign of pathologic finding in the tubes or adhesion or sequel of ectopic pregnancy.
Conclusion: The beneficial outcomes of this kind of treatment suggest that local injection of KCL as a low invasive treatment can be the choice treatment for alive and progressed ectopic pregnancy or heterotopic pregnancy. Because of rarity of this management and successful intrauterine we reported the usefulness of local KCL injection for the successful conservative treatment of alive ectopic pregnancy in Iran.
Full-Text [PDF 247 kb]   (353 Downloads) |   |   Full-Text (HTML)  (15 Views)  
Type of Study: Original Article |

References
1. Abusheikba N, Salha O, Brinssden P. Extrauterine pregnancy following assisted conception treatment. Hum Reprod Update 2000; 5: 80-82. [DOI:10.1093/humupd/6.1.80]
2. Ludwig M, Kaisi M, Bauer O, Diedrich K. Heterotopic pregnancy in a spontaneous cycle: do not forget about it. Eur J Obstet Gynecol Reprod Biol 199l; 87: 91-93. [DOI:10.1016/S0301-2115(99)00079-2]
3. Godin PA, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarean section scar. Fertil Steril 1997; 67: 398-400. [DOI:10.1016/S0015-0282(97)81930-9]
4. Nawroth F, Foth D, Wilhelm L, Schmidt T, Warm M, Romer T.Conservative treatment of ectopic pregnancy in a caesarean section scar with methotrexate: a case report. Eur J Obstet Gynecol Reprod Biol 2001; 99:135-137. [DOI:10.1016/S0301-2115(01)00365-7]
5. Mukul LV, Teal SB. Current Management of Ectopic Pregnancy. Obstet Gynecol Clin N Am 2007; 4: 403-419. [DOI:10.1016/j.ogc.2007.07.001]
6. Stovall TG, Ling FW, Gray LA, Carson SA, Buster JE. Methotrexate treatment of unruptured ectopic pregnancy: a report of 100 cases. Obstet Gynecol 1991; 77: 749-753.
7. Fernandez H, Benifla JL, Lelaidier C, Baton C, Frydman R. Methotrexate treatment of ectopic pregnancy: 100 cases treated by primary transvaginal injection under sonographic control. Fertil Steril 1993; 59: 773-777. [DOI:10.1016/S0015-0282(16)55858-0]
8. Sperrof L, Fritz MA. Clinical Gynecologic endocrinology and infertility. 7th edition. Lippincott. 2005: 1275-1300
9. Roberts H, Kohlenber C, Lanzarone V, Murray H. Ectopic pregnancy in lower segment uterine scar. Aust NZ J Obstet Gynecol 1998; 38: 114-116. [DOI:10.1111/j.1479-828X.1998.tb02976.x]
10. Monteagudo A, Tarricone NJ, Timor-Tritsch IE, Lerner JP. Successful transvaginal ultrasound-guided puncture and injection of a cervical pregnancy in a patient with simultaneous intrauterine pregnancy and a history of a previous cervical pregnancy. Ultrasound Obstet. Gynecol 1996; 8: 381-386. [DOI:10.1046/j.1469-0705.1997.08060381.x]
11. Benifla JL, Fernandez H, Sebban E, Darai E, Frydman R, Madelenat P. Alternative to surgery of treatment of unruptured interstitial pregnancy: 15 cases of medical treatment. Eur J Obstet Gynecol Reprod Biol 1996; 70: 151-156. [DOI:10.1016/S0301-2115(95)02589-8]
12. Rotterdam. The Netherlands.Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.Fertil Steril 2004; 81:19-25. [DOI:10.1016/j.fertnstert.2003.10.004]
13. World Health Organiztion, Laboratory, manual for examination of human sperm and Sperm-mucus interaction. 4th edition. Cambridge University press 1999.
14. Jeng CJ, Ko ML, Shen J. Transvaginal ultrasound-guided treatment of cervical pregnancy. Obstet Gynecol 2007; 109:1076-1082. [DOI:10.1097/01.AOG.0000262052.09350.52]
15. Salomon LJ, Fernandez H, Chauveaud A, Doumerc S, Frydman R .Successful management of a heterotopic Caesarean scar pregnancy: potassium chloride injection with preservation of the intrauterine gestation: case report. Hum Reprod 2003; 18:189-191. [DOI:10.1093/humrep/deg010]
16. Papiernik E, Grangé G, Zeitlin J. Should multifetal pregnancy reduction be used for prevention of preterm deliveries in triplet or higher order multiple pregnancies? J Perinat Med 1998; 26:365-370. [DOI:10.1515/jpme.1998.26.5.365]
17. .Ozgur K, Isikoglu M. Cornual heterotopic pregnancy: conservative treatment with transvaginal embryo reduction. Arch Gynecol Obstet 2005; 271(1):73-75. [DOI:10.1007/s00404-003-0587-5]
18. Verma U, Jacques E.Conservative management of live tubal pregnancies by ultrasound guided potassium chloride injection and systemic methotrexate treatment. J Clin Ultrasound 2005; 33: 460-463. [DOI:10.1002/jcu.20179]
19. Takashima M, Yamasaki M, Fujita I, Ohashi M, Matsuo H, Mochizuki M, et al. Enhanced magnetic resonance imaging in monitoring of conservative treatment of cervical pregnancy. J Obstet Gynaecol 1995; 21: 545-550. [DOI:10.1111/j.1447-0756.1995.tb00910.x]
20. Monteagudo A, Minior VK, Stephenson C, Monda S, Timor-Tritsch IE. Non-surgical management of live ectopic pregnancy with ultrasound -guided local injection:a case series.Ultrasound Obstet Gynecol 2005; 25: 282-288. [DOI:10.1002/uog.1822]
21. Goldstein JS, Ratts VS, Philpott T, Dahan MH. Risk of surgery after use of potassium chloride for treatment of tubal heterotopic pregnancy. Obstet Gynecol 2006; 107:506-508. [DOI:10.1097/01.AOG.0000175145.23512.5e]
22. Raughley MJ, Frishman GN. Local treatment of ectopic pregnancy. Semin Reprod Med 2007; 25:99-115. [DOI:10.1055/s-2007-970049]
23. Gyamfi C, Cohen S, Stone JL. Maternal complication of cervical heterotopic pregnancy after successful potassium chloride fetal reduction. Fertil Steril 2004; 82:940-943. [DOI:10.1016/j.fertnstert.2004.03.044]
24. Ujvari E, Krizsa F, Sebestyen A, Varbiro S, Paulin F. Successful management of intrauterine twin and concomitant cervical pregnancy: a case report. Fetal Diagn Ther 2006; 21:181-184. [DOI:10.1159/000089300]
25. Frates MC,Benson cb, Doubilet PM. Cervical ectopic pregnancy :results of conservative treatment. Radiology 1994; 191:773. [DOI:10.1148/radiology.191.3.8184062]
26. Benifla JL, Fernandez H, Sebban E, Darai E, Frydman R, Madelenat P. Alternative to surgery of treatment of unruptured interstitial pregnancy: 15 cases of medical treatment. Eur J Obstet Gynecol Reprod Biol 1996: 27; 70:151-156. [DOI:10.1016/S0301-2115(95)02589-8]
27. Ghazeeri GS, Phillips OP, Emerson DS, Kutteh WH, Ke RW. Live birth after treatment of a heterotopic cornual pregnancy with fetal intrathoracic KCI. A case report. J Reprod Med 2002; 47:1038-1040.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


© 2019 All Rights Reserved | International Journal of Reproductive BioMedicine

Designed & Developed by : Yektaweb