A Case Report on Management of Recurrent Ectopic PregnancyA Medical Success

Abstract

Recurrent ectopic cases have been on the rise as there is increase in Artificial Reproductive Techniques (ART) recently. Earlier patient presentation and more precise diagnosis by proper clinical examination and with proper interpretation of serial β-human Chorionic Gonadotropin (β-hCG) allows identification of an ectopic pregnancy before ruptures and differentiates from other common conditions like infection, miscarriage, degenerating leiomyomas or pain around ligament. Various studies have been conducted over time to set a discriminatory zone for β-hCG. Initially, the cut-off for β-hCG was taken to be 1000-2000 mIU/mL. But now the cut-off has been increased to 3510 mIU/mL. Methotrexate has been used as first line drug in medical management of ectopic pregnancy for a long time. But methotrexate has been used with caution when laboratory values show a high β-hCG. Here, authors report a case of a 29- year-old female with recurrent ectopic pregnancy which was successfully managed with methotrexate therapy despite the initial high β-hCG values thus avoiding a surgical intervention.