A case of a methotrexate-resistant ectopic pregnancy in which dactinomycin was effective as a second-line chemotherapy
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/m2 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.
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S.F. has nothing to disclose. Y.Y. has nothing to disclose. S.K. has nothing to disclose. H.K. has nothing to disclose. Y.T. has nothing to disclose. M.O. has nothing to disclose.
This work was presented at the meeting of the Japan Society of Obstetrics and Gynecology 2008.
PII: S0015-0282(08)04130-7
doi:10.1016/j.fertnstert.2008.10.003
© 2009 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
