carboprost and Pregnancy--Ectopic

Cervical pregnancy, an uncommon variety of ectopic gestation is associated with high morbidity and adverse consequences for future fertility. Currently there are no specific recommendations for the best treatment of this entity.. A 35-year-old nullipara presented with 8 weeks of amenorrhea and painless brown discharge. The patient was diagnosed with cervical pregnancy with embryonic cardiac activity. A conservative surgical treatment under general anesthesia involved intracervical infiltration of carboprost, cerclage, suction curettage of cervix, and Foley balloon tamponade was performed. The Foley was removed on day 2 and the cerclage on day 7.. Early cervical pregnancy was treated with combined cervical cerclage, intracervical infiltration of carboprost, curettage, and balloon tamponade. Severe hemorrhage during suction curettage and the adverse effects and complications of systemic methotrexate treatment were avoided.

Topics: Abortifacient Agents, Nonsteroidal; Adult; Carboprost; Catheterization; Cerclage, Cervical; Combined Modality Therapy; Diagnosis, Differential; Dilatation and Curettage; Female; Humans; Pregnancy; Pregnancy Trimester, First; Pregnancy, Ectopic; Vaginal Discharge

A patient treated with mifepristone (RU 486), which successfully induced abortion of an intrauterine pregnancy, was discovered to have a heterotopic ovarian pregnancy resistant to this antiprogesterone. The ovarian pregnancy was removed with operative laparoscopy. This case demonstrates for the first time that an ovarian pregnancy may be resistant to treatment with RU 486 at a dose adequate to abort an intrauterine pregnancy.

Topics: Abortion, Induced; Adult; Carboprost; Female; Humans; Laparoscopy; Mifepristone; Ovary; Pregnancy; Pregnancy, Ectopic