Salpingoscopy after a single dose of methotrexate for treatment of tubal pregnancy

摘要

A 35-year-old woman was referred to Macedonio Melloni Hospital, Milan, Italy, to undergo laparoscopy as a diagnostic test for infertility.Fourteen months earlier, the patient had been successfully treated for a right-sided tubal pregnancy with a single dose of systemic metho-trexate (50 mg/m2). On the day of methotrexate administration, serum levels of human chorionic gonadotropin had peaked at 2949 mlU/mL and ultrasound had confirmed a right-sided ampullary pregnancy.Laparoscopy showed bilateral tubal patency. Salpingoscopy was performed using a standard 2.9-mm diagnostic hysteroscope, with a 3.7-mm single-flow diagnostic sheath, introduced through an accessory port. It demonstrated normal tubal mucosa (grade 1 [1 ]) throughout the entire ampullary portion of the tube (Fig, 1).