Medical Treatment of Tubar Ectopic Pregnancy with Living Embryo: About Two Cases in Dakar (Senegal)

O. Gassama, B. Biaye, Aminata Niass, M. Cissé, Altaweel Ar, M. Diallo, A. Diouf, P. Moreira, J. Moreau
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Abstract

Objectives: To evaluate the efficacy of treatment with methotrexate, and the possibility of medical treatment of living embryo. Observation: We report two cases in secondary amenorrhea of 6 weeks received in an algebra table associated with minimal bleeding. The physical examination had found moderate pain in the left iliac fossa for the first patient and for the second patient in the right iliac fossa with minimal bleeding. The first endo-vaginal ultrasound showed a left lateral uterine mass, the second one a right lateral uterine mass containing a living embryo of sixweek amenorrhea. We administered a triple dose of methotrexate to both patients whose improvement could be noticed trough a clinical remission and a decrease of the plasmatic βHCG level. Consequently, we decided to release them after 8 days of hospitalization. Conclusion: The medical treatment of tubal ectopic pregnancy with living embryo is difficult due to the work conditions; furthermore, it is a controversial issue in our country.
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活胎输卵管异位妊娠的医学治疗——附塞内加尔达喀尔2例报告
目的:评价甲氨蝶呤治疗活胚的疗效及医学治疗的可能性。观察:我们报告2例继发性闭经6周,在代数表中接受少量出血。体格检查发现1例患者左髂窝中度疼痛,2例患者右髂窝轻度出血。第一次阴道内超声显示左侧子宫肿块,第二次子宫右侧肿块包含一个六周闭经的活胚胎。我们给两名患者三剂量甲氨蝶呤,他们的改善可以通过临床缓解和血浆βHCG水平下降而被注意到。因此,我们决定在住院8天后让他们出院。结论:受工作条件的限制,活胎输卵管异位妊娠的医疗难度较大;此外,这在我国是一个有争议的问题。
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