Conservative management of live tubal pregnancies by ultrasound guided potassium chloride injection and systemic methotrexate treatment

Usha Verma, Elvire Jacques

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Unruptured live tubal ectopic pregnancies are often managed surgically. Significantly elevated β-hCG levels in these patients make treatment with methotrexate ineffective. However, achieving cardiac asystole via sonographically guided injection of potassium chloride (KCI) along with systemic methotrexate can improve treatment outcome. We describe the successful conservative management of 3 cases of unruptured tubal pregnancy with cardiac activity and significantly elevated β-hCG levels. Under sonographic guidance, KCI was injected into the fetal heart to achieve cardiac asystole, and patients concurrently received a systemic methotrexate injection. The resolution of ectopic pregnancy was achieved and surgery was avoided in all 3 cases. Conservative management may thus be an option for patients with live ectopic pregnancies.

Original languageEnglish (US)
Pages (from-to)460-463
Number of pages4
JournalJournal of Clinical Ultrasound
Volume33
Issue number9
DOIs
StatePublished - Dec 1 2005

Keywords

  • β-hCG
  • Cardiac activity
  • Ectopic pregnancy
  • Methotrexate
  • Potassium chloride

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics

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