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    Medical management of ectopic pregnancy with extremely high ?-HCG levels: A case report
    (2004) Yüce M.A.; Gücer F.; Balkanli-Kaplan P.; Sayin N.C.
    We report the successful treatment of an unruptured ectopic pregnancy in a patient with extremely high ?-human chorionic gonadotropin concentrations. A 33-year-old woman, gravida 2, para 0, abortus 1, presented to our department due to menstrual delay. On transvaginal ultrasonography, she had an unruptured ectopic pregnancy (3.5 × 4.5 cm). Her initial ?-HCG concentration was 38,270 mIU/ml. The administration of methotrexate (50 mg/m2) was performed intramuscularly. Serum ?-HCG levels decreased > 15% between post-therapy days 4 (31,324 mIU/ml) and 7 (13,108 mIU/ml), and did not rise during the subsequent weekly controls. In selected cases with unruptured ectopic pregnancy and extremely high initial ?-HCG levels, medical management with a single-dose methotrexate regimen may be successful.
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    Placenta percreta diagnosed after first-trimester pregnancy termination: A case report
    (2006) Balkanli-Kaplan P.; Gucer F.; Oz-Puyan F.; Yuce M.A.; Kutlu K.
    BACKGROUND: Placenta percreta in early pregnancy has been documented in only a few cases. This is the first report of placenta percreta diagnosed after an extended period from pregnancy termination. CASE: A woman with a history of a previous cesarean section presented with heavy and irregular vaginal bleeding beginning immediately after pregnancy termination at 7 weeks' gestation. Failed response to hormonal treatment and curettage necessitated hysterectomy. Histologic examination revealed a placenta percreta. CONCLUSION: Although placenta percreta is an uncommon occurrence, clinicians should consider it in patients who have a uterotomy scar and complain of long-term metrorrhagia following pregnancy termination. © Journal of Reproductive Medicine®, Inc.