What is pseudosac of ectopic gestation?? What risk can be there if too early Mifepristone or methotrexate is administered in a IUP(inert uterine pregancy)?? Ans: .. A “pseudosac” is a collection of fluid within the endometrial cavity itself, created by bleeding from the decidualized endometrium associated with an extrauterine pregnancy implantation. Every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment for presumed ectopic pregnancy. Indirect way of diag of EP:- Transvaginal ultrasound image of a fluid collection within the endometrial cavity, a pseudosac, consistent with an extrauterine pregnancy.
The diagnosis of ectopic pregnancy, unless directly visualized with transvaginal ultrasound, is made with following four landmarks: A) exclusion of an intrauterine pregnancy. B) Measurement of human chorionic gonadotrophin and C) progesterone levels, and D) transvaginal ultrasound are the tools used to evaluate early pregnancy. In women at risk for an ectopic pregnancy, every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment course(MTP pill).
Methotrexate is an antimetabolite that inhibits DNA synthesis and repair and cell replication. It is administered to ostensible destroy a pregnancy, especially ectopic pregnancies. When administered to an intrauterine pregnancy, embryonic death and missed abortion is the most common result, but early embryos that survive this exposure are likely to have multiple anomalies. This also applies to Mifepristone also.
Methotrexate is an antimetabolite that inhibits DNA synthesis and repair and cell replication. It is administered to ostensible destroy a pregnancy, especially ectopic pregnancies. When administered to an intrauterine pregnancy, embryonic death and missed abortion is the most common result, but early embryos that survive this exposure are likely to have multiple anomalies. This also applies to Mifepristone also.
What can go wrong in clinical practice?? The mistaken administration of methotrexate to an intrauterine pregnancy is made because of 1`) misinterpretation of the discriminatory zone of human chorionic gonadotropin (hCG), 2) misinterpretation of early hCG serum levels, 3) misinterpretation of early transvaginal ultrasound images, and 4) failure to clinically correlate hCG levels and ultrasound findings.
In women at risk for an ectopic pregnancy, every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment course.
In women at risk for an ectopic pregnancy, every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment course.
Methotrexate is an antimetabolite that inhibits DNA synthesis and repair and cell replication. Mifepristone cause progesterone block. It such drugs are administered to ostensible destroy a pregnancy, especially ectopic pregnancies. When administered to an intrauterine pregnancy, embryonic death and missed abortion is the most common result, but few early embryos that survive this exposure are likely to have multiple anomalies.
In women at risk for an ectopic pregnancy, every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment for ectopic pregnancy, such as the administration of methotrexate/ Mifepristone. When methotrexate is administered to an intrauterine pregnancy, embryonic death with missed abortion is the most common result, but case reports of methotrexate embryopathy have described embryos that have survived early Mifepristone / methotrexate exposure
In women at risk for an ectopic pregnancy, every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment for ectopic pregnancy, such as the administration of methotrexate/ Mifepristone. When methotrexate is administered to an intrauterine pregnancy, embryonic death with missed abortion is the most common result, but case reports of methotrexate embryopathy have described embryos that have survived early Mifepristone / methotrexate exposure
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