A Clinical Study of Unruptured Ectopic Pregnancies with the Treatment of Systemic or Local Methotrexate Injecton / 대한산부인과학회잡지
Korean Journal of Obstetrics and Gynecology
;
: 616-624, 2000.
Artigo
em Coreano
| WPRIM
| ID: wpr-123520
ABSTRACT
OBJECTIVE:
To evaluate safety and efficacy of systemic or local methotrexate(MTX) injection to patients with unruptured ectopic pregnancyMETHODS:
From October 1995 to October 1999, 35 unruptured ectopic pregnancies were eligible for the conservative management. 25 tubal pregnancies, 4 cervical pregnancies, 4 pregnancies of previous cesarean section scar, and 2 cornual pregnancies diagnosed by ultrasonography & serumbeta-hCG were evaluated. Patients were treated with one of following three protocols (1) A single-dose of 50mg/m2 of intramuscullar(IM) MTX(7 cases) (2) Two to four doses of 1.0mg/kg of IM MTX with citrovorum rescue(20 cases) (3) Transvaginal ultrasonogram-guided intra-amniotic instillation of 50mg methotrexate (8 cases) The mean age of these patients was 30.8 yrs (range 24-42) and gestational age at diagnosis ranged from 22-75 days (mean 47). Initial level of serumbeta-hCG ranged from 166.4-55363.8 mIU/mL (mean 9069.2). Patients were monitored with serumbeta-hCG titers three times per week ,and then weekly until the serumbeta-hCG level was less then 10 mIU/mL.RESULT:
31 of 35 patients (88.6%) were successfully treated and remaining 4 patients failed conservative therapy and so required surgery. Mean duration of resolution was 38.5 days (range 11-105). Side effect rate was 45.7% but severity of symptoms were so mild that no treatment was needed in most cases.CONCLUSION:
Nonsurgical conservative management of MTX appears to be effective and safe treatment modality for some selected unruptured ectopic pregnancy. But further comparative studies and long-term follow-up are needed to evaluate reproductive outcome and reduce side effects of MTX.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Gravidez Ectópica
/
Gravidez Tubária
/
Cesárea
/
Metotrexato
/
Seguimentos
/
Ultrassonografia
/
Idade Gestacional
/
Cicatriz
/
Diagnóstico
Tipo de estudo:
Estudo diagnóstico
/
Guia de Prática Clínica
/
Estudo observacional
/
Estudo prognóstico
Limite:
Feminino
/
Humanos
/
Gravidez
Idioma:
Coreano
Revista:
Korean Journal of Obstetrics and Gynecology
Ano de publicação:
2000
Tipo de documento:
Artigo
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