Patient | Initial treatment | Complications | Management of complications | Hospitalisation (days) | Imagistic surveillance: TVUS and color Doppler | hCG surveillance |
---|---|---|---|---|---|---|
1 | Medical: Methotrexate 1 mg/kg, 5 doses, alternate days | No complications, spontaneous resolution of pregnancy | N/A | 9 | 3-months posttreatment: normal uterus and isthmic caesarean scar | 98 days follow up until negative |
2 | Medical: Methotrexate 1 mg/kg, 5 doses, alternate days | Increase hCG levels Persistence of pregnancy and local trophoblastic vascularization | Surgical: D&C and local haemostasis with Foley catheter for 48 h | 11 | still on surveillance | Decreasing trend of hCG |
3 | Medical: Mifepristone, Methotrexate, 1 mg/kg | Increase hCG levels Spontaneous miscarriage with heavy vaginal bleeding | Surgical, D&C under US guidance haemostasis with uterine-vaginal pack | 13 | 6-months post treatment: normal uterus and uterine scar | < 10 |
4 | Medical: Mifepristone, Methotrexate, 1 mg/kg | No complications, spontaneous resolution of pregnancy | N/A | 10 | 1-month post treatment Normal uterus and uterine scar | <  5 |
5 | Surgical: D&C | Persistence of vascularised trophoblast | Medical: Methotrexate, 1 mg/kg x 1dose Surgical: D&C and haemostasis with Foley catheter | 11 | 2-years posttreatment Normal appearance of anterior wall of the uterus normal and caesarean scar | Follow up another centre |
6 | Surgical: emergency D&C | Spontaneous miscarriage with heavy vaginal bleeding Persistence of pregnancy, presence of isthmic mass with rich vascularization and possible accreta | Surgical: D&C haemostasis Foley catheter & blood transfusion Surgical: Total abdominal hysterectomy | 9 | N/A | <  64 mUI/mL |