Intraamniotic Methotrexate Administration for Unruptured Tubal Ectopic Gestation: A Case Report

Abstract

A case of unruptured right tubal ectopic gestation in a 28 year old Gravida 2 Para 0+1 who presented at 6 weeks 2 days gestation with an ultrasound report showing an unruptured right tubal ectopic gestation. The serum beta hcg was 22,824.97miu/ml and there was fetal cardiac activity. She initially had a single dose of intramuscular methotrexate administered but pregnancy still persisted. She then had methotrexate administered into the gestational sac under ultrasound guidance nine days later with complete resorption of the ectopic gestation and return of normal serum beta hcg values within two weeks. This case demonstrates that not all ectopic pregnancies must be managed surgically. It also shows the extent one might need to go in achieving success when one conservative method fails.