SUCCESSFUL TREATMENT OF AN ADVANCED INTERSTITIAL PREGNANCY BY SEQUENTIAL SYSTEMIC AND LOCAL-ADMINISTRATION OF METHOTREXATE

A patient is presented with an advanced interstitial pregnancy, diagnosed by transvaginal ultrasound and confirmed by laparoscopy, Amenorrhoea at the time of diagnosis was 57 days, Methotrexate was given systemically (4x50 mg i.m.), Because of persisting viability of the fetus, systemic methotrexate treatment was followed by local instillation of methotrexate into the gestational sac (50 nag), FoIlow-up revealed rapid human chorionic gonadotrophin regression but slow regression of fetal remnants.