High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report.

Journal: Medicine
Treatment Used: High-Intensity Focused Ultrasound Ablation Combined with Methotrexate
Number of Patients: 1
MediFind Summary

Summary: This case report describes a 32-year-old woman with an intramural ectopic pregnancy (IMP) treated with high-intensity focused ultrasound ablation combined with methotrexate.

Conclusion: A woman with an intramural ectopic pregnancy was successfully treated with high-intensity focused ultrasound ablation combined with methotrexate.


Background: Intramural ectopic pregnancy (IMP) is a rare ectopic pregnancy with an unclear etiology, and standard treatment guidelines currently remain unclear. The main treatment option is local excision of IMP via laparoscopy or laparotomy.

Methods: A 32-year-old woman with adenomyosis presented with amenorrhea for 7 weeks and a serum β-human chorionic gonadotropin (HCG) level of 6882 IU/L. The patient had a history of laparotomy for adenomyosis 5 years previously. Three-dimensional ultrasonography showed a live gestational sac (GS) of 9 × 15 × 18 mm located in the left posterior wall of the uterus and a sinus tract connecting the sac and the endometrial cavity. MRI revealed the GS located in the adenomyosis and a 1.0-cm sinus tract connecting the GS and the endometrial cavity. Methods: IMP with adenomyosis. Methods: High-intensity focused ultrasound (HIFU) treatment combined with systemic methotrexate (MTX) was performed to treat IMP, which would avoid operation and massive bleeding.

Results: Serum β-HCG levels decreased to normal 4 weeks after HIFU treatment and the GS was not found on MRI after 4 months. The sinus tract was significantly shortened after the HIFU treatment.

Conclusions: HIFU ablation combined with systemic MTX is effective for the treatment of IMP and is favorable for maintaining fertility.

Yan Peng, Yu Dai, Guiyuan Yu, Ping Jin
Relevant Conditions

Adenomyosis, Ectopic Pregnancy

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