Intragestational injection of methotrexate

Jodi P. Lerner, Sarah Horvath, Khara Simpson

Research output: Contribution to journalArticlepeer-review


The presentation of a cesarean scar ectopic pregnancy can at times be daunting, especially without familiarity regarding its management. Women with cesarean scar ectopic pregnancy most often have no symptoms, although vaginal bleeding and abdominal pain can present. Upon visual diagnosis with transabdominal or transvaginal ultrasound, the preferred treatment method is direct injection of methotrexate into the gestational sac within the cesarean scar.

In this video, my colleagues review the indications and contraindications for direct injection of methotrexate as well as alternative treatment methods for this type of nonviable pregnancy that is increasing in frequency (given the US cesarean delivery rate). Demonstrated is the technique for methotrexate injection in the case of a 34-year-old woman (G6P0232) with ultrasound and beta−human chorionic gonadotropin confirmation of cesarean scar ectopic pregnancy.

We hope this video serves as a useful reference in your practice.
Original languageEnglish (US)
Pages (from-to)39
JournalOBG Management
Issue number8
StatePublished - Aug 2015


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