RESUMO
The objective of this study is to describe the clinical outcomes of patients treated for cervical pregnancy with or without methotrexate (MTX) and to evaluate the effects of MTX in the treatment of cervical pregnancy. Between January 1993 and February 2000, 31 patients were diagnosed with cervical pregnancy. Twenty-two patients were treated with MTX chemotherapy and nine patients were treated with surgical procedures without MTX treatment. In the non-MTX treatment group, three patients underwent total abdominal hysterectomy, five required adjuvant procedures to control the bleeding during dilatation and curettage (D&C) and only one patient was treated with a simple D&C. In the MTX treatment group, fourteen (63.6%) patients were treated with only MTX and eight (36.4%) cases underwent concomitant procedures (simple curettage, curettage and Foley catheter tamponade, cer-vical cerclage, ligation of the descending branches of uterine arteries, or ligation of hypogastric arteries). The uterus was preserved in all cases and three women delivered healthy babies in their subsequent pregnancy. In conclusion, early diagnosis, appropriate MTX regimen in combination of necessary adjuvant conservative procedures could contribute to successful treatment with preservation of the uterus and future reproductive ability.
Assuntos
Feminino , Humanos , Gravidez , Abortivos não Esteroides/administração & dosagem , Estudo Comparativo , Dilatação e Curetagem/estatística & dados numéricos , Incidência , Coreia (Geográfico)/epidemiologia , Metotrexato/administração & dosagem , Gravidez Ectópica/tratamento farmacológico , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Resultado do TratamentoRESUMO
En 211 pacientes se estudian las caracteríscas clínicas y ultrasonográficas que permiten plantear el diagnóstico de aborto completo. Se evalúa el rendimiento del diagnóstico clínico y las características al ultrasonido, con el fin de reducir el error diagnóstico y disminuir las complicaciones producto de esa falla. La precisión del diagnóstico clínico de aborto completo fue similar en los dos grupos estudiados (Grupo 1: diagnóstico clínico exclusivo; Grupo: 2: diagnóstico clínico más característica ecográficas): 95,2 por ciento y 94,4 por ciento respectivamente. El grosor endometrial fue el único elemento ultrasonográfico útil para determinar la paciente con riesgo de legrado posterior por restos ovulares. Con grosor mayor de 15 mm hubo un RR de 15,6 y con 20 mm, RR de 31