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首页> 外文期刊>Fertility and Sterility: Official Journal of the American Fertility Society, Pacific Coast Fertility Society, and the Canadian Fertility and Andrology Society >Importance of timing of gestational exposure to methotrexate for its teratogenic effects when used in setting of misdiagnosis of ectopic pregnancy.
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Importance of timing of gestational exposure to methotrexate for its teratogenic effects when used in setting of misdiagnosis of ectopic pregnancy.

机译：当用于异位妊娠误诊时，妊娠暴露于甲氨蝶呤的时间对其致畸作用的重要性。

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OBJECTIVE: To report a case of embryopathy due to misadministration of methotrexate in the setting of suspected ectopic pregnancy that resulted in a different pattern of malformations than is typically seen with methotrexate. DESIGN: Case report. SETTING: Community hospital. PATIENT(S): A 30-year-old primigravida women exposed to methotrexate (50 mg/m(2)) at 5 6/7 weeks' gestation. INTERVENTION(S): The patient underwent amniocentesis because of abnormal results at the first-trimester genetic screening (low levels of pregnancy associated plasma protein A and hCG) and fetal echocardiogram because of single umbilical artery. MAIN OUTCOME MEASURE(S): Fetal anomalies. RESULT(S): The fetus was found to have a single umbilical artery, tetralogy of Fallot, and a horseshoe lung, pregnancy ultimately ended with fetal demise at 30 weeks. CONCLUSION(S): As medical management of ectopic pregnancy becomes more common, practitioners should be cautious about the potential teratogenic effects in unrecognized intrauterine pregnancies and be able to diagnose the myriad defects, including cardiac anomalies, that could result from such exposure.
机译：目的：报告一例在怀疑异位妊娠的情况下因甲氨蝶呤使用不当而引起的胚胎病，该畸形导致的畸形模式与甲氨蝶呤不同。设计：病例报告。地点：社区医院。患者：一名30岁的初产妇在妊娠5 6/7周时暴露于甲氨蝶呤（50 mg / m（2））。干预：由于在妊娠前三个月的遗传筛查结果异常（与妊娠相关的血浆蛋白A和hCG含量低）和胎儿超声心动图检查（单胎脐动脉），患者接受了羊膜穿刺术。主要观察指标：胎儿异常。结果：发现胎儿具有单条脐动脉，法洛氏四联症和马蹄肺，怀孕最终在30周时以胎儿死亡而告终。结论：随着异位妊娠的医疗管理变得​​越来越普遍，从业者应对未认识的宫内妊娠的潜在致畸作用保持谨慎，并能够诊断出此类暴露可能导致的多种缺陷，包括心脏异常。

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