Clinical Guidelines for Methotrexate in Conservative Treatment for Ectopic Pregnancy / 대한산부인과학회지
Korean Journal of Obstetrics and Gynecology
;
: 2635-2644, 2005.
Artigo
em Coreano
| WPRIM
| ID: wpr-66578
ABSTRACT
OBJECTIVE:
To provide more useful guidelines for methotrexate (MTX) treatment in ectopic pregnancy, including patient selection, therapeutic dose, and reproductive outcome.METHODS:
Retrospectively, records of 54 patients treated for ectopic pregnancy with systemic MTX were reviewed. MTX was administered 1.0 mg/kg intramuscularly, alternatively with leucovorin 0.1 mg/kg intramuscularly for up to four daily doses of each drug. Samples for beta-hCG detection were obtained on days +3, +7 after beginning of the therapy and then weekly until values were undetectable.RESULTS:
50 patients (92.6%) were treated successfully. 4 patients (7.4%) for whom MTX therapy failed, were treated surgically. The endometrial thickness significantly increased in the failed group, compared to the successful group (14.3+/-4.0 mm vs 7.0+/-2.8 mm, P=0.0001). The serum hemoglobin levels significantly changed in the failed group, compared to the successful group (2.1+/-0.9 g/dL vs 1.0+/-0.8 g/dL, P=0.044). Patients were divided into increasing group and decreasing group according to beta-hCG levels on day 0, that were higher or lower than day -2 level. The resolution time of beta-hCG between increasing group and decreasing group was significantly different (27.6+/-14.0 days vs 17.7+/-8.6 days, p=0.016). In 8 patients (15.1%), an immediate rise of beta-hCG was recorded on day 3 after MTX treatment, but on day 7, a rapid decrease was recorded. Women were treated with significantly different therapeutic dose of MTX according to initial level of serum beta-hCG (p=0.021). There were mild complications (12%). MTX treatment preserved the fallopian tube and thus preserved fertility (70%).CONCLUSION:
Systemic MTX use with the dose according to initial level of serum beta-hCG is a safe and highly effective treatment in clinically stable ectopic pregnancy.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Gravidez Ectópica
/
Metotrexato
/
Leucovorina
/
Estudos Retrospectivos
/
Seleção de Pacientes
/
Tubas Uterinas
/
Fertilidade
Tipo de estudo:
Guia de Prática Clínica
/
Estudo observacional
Limite:
Feminino
/
Humanos
/
Gravidez
Idioma:
Coreano
Revista:
Korean Journal of Obstetrics and Gynecology
Ano de publicação:
2005
Tipo de documento:
Artigo
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