RESUMO
OBJECTIVE: The purpose of this study was to determine the efficacy of multiple dose methotrexate (MTX) chemotherapy approved as a primary treatment of ectopic pregnancy in suspected medical treatment failure of ectopic pregnancy. METHODS: This study included 77 hemodynamically stable high risk ectopic pregnants diagnosed from January 1995 to June 2000 at department of Obstetrics & Gynecology, Sanggye Paik hospital, Inje university. High risk criteria of our study were adnexal ectopic mass 3.5 cm or serum-hCG 4,000 mIU/ml or presence of fetal heart beat(FHB) or presence of peritoneal fluid and fresh blood on culdocentesis. Statistics were analyzed with 2-test, Student t-test and odds ratio of each risk factors. RESULTS: The response rate of multiple dose MTX chemotherapy was 85.7%(66/70). There was no statistically difference of risk factors between success and failure group except fetal heart beat. Among 11 failure patients, there were 3 patients with adnexal ectopic mass 3.5 cm (odds ratio=1.4, 0.3~5.7), 3 patients with presence of FHB, 7 patients with presence of peritoneal fluid(odds ratio=1.0, 0.3~3.8), 8 patients with serum-hCG 4,000 mIU/ml (odds ratio=2.8, 0.7~11.6). CONCLUSION: There results suggest that multiple dose MTX chemotherapy can be treated regardless of ectopic mass size, presence of pretoneal fluid, serum beta-hCG level. But we must pay attention to treat ectopic pregnancy with presence of fetal heart beat.
Assuntos
Feminino , Humanos , Gravidez , Líquido Ascítico , Tratamento Farmacológico , Coração Fetal , Ginecologia , Metotrexato , Obstetrícia , Razão de Chances , Gravidez Ectópica , Fatores de Risco , Falha de TratamentoRESUMO
Fetal intussusception is not common and the underlying mechanism triggering the event is not known at present. There are few reports of successful diagnosis in fetus with prenatal ultrasongraphy. It may be detected by meconium peritonitis. Meconium peritonitis is a nonbacterial foreign body reaction or chemical inflammation by intestinal perforation result from intestianl atresia, intussusception and fetal bowel obstruction. Recently we experienced a 33+1 weeks of gestational fetus with fetal intussusception who had prenatal ultrasonographic detection with meconium peritonitis, and the infant was underwent postnatal laparotomy. We present this case with a brief review of literature.
Assuntos
Humanos , Lactente , Diagnóstico , Feto , Reação a Corpo Estranho , Inflamação , Perfuração Intestinal , Intussuscepção , Laparotomia , Mecônio , Peritonite , Diagnóstico Pré-NatalRESUMO
No abstract available.