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Dual extrauterine ectopic pregnancy: double management
  1. Chandana S Bhat,
  2. N Sanjeeva Reddy,
  3. Radha Vembu and
  4. Monna Pandurangi
  1. Department of Reproductive Medicine and Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  1. Correspondence to Dr Radha Vembu; ganesh_radha{at}yahoo.in

Abstract

A 30-year-old nulliparous woman was referred with suspected left ovarian ectopic pregnancy. She had undergone laparoscopic left salpingectomy for ruptured tubal ectopic pregnancy 3 weeks earlier, following treatment with medications for ovulation induction. Sonological examination revealed a left ovarian ectopic pregnancy corresponding to 8 0/7 weeks with cardiac activity. She underwent ultrasound-guided intrasac therapy with intrasac instillation of 3 mEq of potassium chloride followed by 50 mg of methotrexate. She was followed with weekly measurements of serum beta human Chorionic Gonadotropin (hCG) which returned to baseline after 65 days of the intrasac therapy. This case not only highlights the need for continued follow-up of the serum beta hCG after definitive management of an ectopic pregnancy in cases with multiple ovulations, but also the option of medical management in cases of advanced ovarian ectopic pregnancy. It also accentuates the necessity for adequate counselling to avoid conception in a multiple ovulation cycle.

  • obstetrics
  • gynaecology and fertility
  • medical management

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Footnotes

  • Contributors NSR came up with the idea of conservative management of the ovarian ectopic pregnancy. NSR, RV and MP performed the procedure. CSB drafted the manuscript. RV, NSR and MP have revised the manuscript critically for important intellectual content. All authors approved the final version of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.