Case Report
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Tekrarlayan Ektopik Gebelik Olgusunda Organ Koruyucu Metotreksat Tedavisi: Vaka Sunumu

Year 2024, , 73 - 76, 09.06.2024
https://doi.org/10.46969/EZH.1472903

Abstract

Amaç: Tekrarlayan ektopik gebelik olgularında tanı, tedavi ve yönetim yaklaşımlarının önemini değerlendirmek.
Gereç ve Yöntem: Bu çalışmada, sol tubal ektopik gebelik ve ardından sol salpenjektomi öyküsü olan ve sağ tubal ektopik gebelik nedeni ile başvuran 31 yaşında bir kadının yönetimi sunulmaktadır. Kontraendikasyon olmaması nedeni ile metotreksat (MTX) tedavisi başlandı. MTX’in ilk gününde hastanın serum βhCG düzeyi 5135,64 U/L idi ancak yükselmeye devam etti. Daha sonra hastaya ikinci doz MTX uygulandı. İkinci MTX dozunun dördüncü gününde serum βhCG düzeyi 8333,98 U/L iken ikinci MTX dozunun beşinci gününde βhCG düzeyi dramatik bir şekilde 6819,35 U/L’ye düştü. İkinci doz MTX tedavisinden 22 gün sonra serum βhCG düzeyi 848.76 U/L idi. Transvajinal ultrasonda ektopik kitlede azalma görüldü.
Sonuç: Tubal ektopik gebeliklerin erken tanısı tıbbi müdahale yoluyla başarılı bir şekilde yönetilebilir ve bu da yüksek başarı oranı gösterir.

Ethical Statement

Olgu Sunumu olduğu için etik kurul kararı alınmamıştır. Hastanın sözlü ve yazılı onamı mevcuttur.

Thanks

Yok

References

  • Ray A, Gaur A, Kumari S. Predictors of Successful Medical Management With Methotrexate in Unruptured Tubal Ectopic Pregnancy. Cureus. 2022;14(11):e31923. https://doi.org/10.7759/cureus.31923
  • Mullany K, Minneci M, Monjazeb R, C Coiado O. Overview of ectopic pregnancy diagnosis, management, and innovation. Womens Health (Lond). 2023;19:17455057231160349. https://doi.org/10.1177/17455057231160349
  • Hendriks E, Rosenberg R, Prine L. Ectopic Pregnancy: Diagnosis and Management. Am Fam Physician. 2020;101(10):599-606.
  • Akdaş Reis Y, Özkan M, Yılmaz Ergani S, et al. Latest trend ectopic pregnancy management in a tertiary health center: a retrospective cohort study. Perinatal Journal. 2022;30(3):308-13. https://doi.org/10.2399/prn.22.0303013
  • Xiao C, Shi Q, Cheng Q, Xu J. Non-surgical management of tubal ectopic pregnancy: A systematic review and meta-analysis. Medicine (Baltimore). 2021;100(50):e27851. https://doi.org/10.1097/MD.0000000000027851
  • Lipscomb GH, Givens VA, Meyer NL, Bran D. Previous ectopic pregnancy as a predictor of failure of systemic methotrexate therapy. Fertil Steril. 2004;81(5):1221-4. https://doi.org/10.1016/j.fertnstert.2003.09.070
  • Khalil A, Saber A, Aljohani K, Khan M. The Efficacy and Success Rate of Methotrexate in the Management of Ectopic Pregnancy. Cureus. 2022;14(7):e26737. https://doi.org/10.7759/cureus.26737
  • Karadeniz RS, Tasci Y, Altay M, Akkuş M, Akkurt O, Gelişen O. Tubal rupture in ectopic pregnancy: is it predictable? Minerva Ginecol. 2015;67(1):13-9.
  • Karadeniz RS, Dilbaz S, Özkan SD. Unilateral twin tubal pregnancy successfully treated with methotrexate. Int J Gynaecol Obstet. 2008;102(2):171. https://doi.org/10.1016/j.ijgo.2008.03.012

Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report

Year 2024, , 73 - 76, 09.06.2024
https://doi.org/10.46969/EZH.1472903

Abstract

Objective: To assess the significance of diagnosis, treatment, and management approaches in cases of recurrent ectopic pregnancies.
Material and Method: This study presents the management of a 31-year-old woman with a history of left tubal pregnancy and subsequent left salpingectomy, who presented with a right tubal ectopic pregnancy. Methotrexate (MTX) treatment was initiated due to the absence of contraindications. On the first day of MTX, the patient’s serum βhCG level was 5135.64 U/L, but it continued to rise. Subsequently, the patient received a second dose of MTX. On the fourth day of the second MTX dose, the serum βhCG level was 8333.98 U/L, while on the fifth day of the second MTX dose, the βhCG level dropped dramatically to 6819.35 U/L. Twenty-two days after the second dose of MTX treatment, the serum βhCG level was 848.76 U/L. Transvaginal ultrasound revealed a decrease in the ectopic mass.
Conclusion: Early diagnosis of tubal ectopic pregnancies can be effectively managed through medical intervention, demonstrating a high success rate.

References

  • Ray A, Gaur A, Kumari S. Predictors of Successful Medical Management With Methotrexate in Unruptured Tubal Ectopic Pregnancy. Cureus. 2022;14(11):e31923. https://doi.org/10.7759/cureus.31923
  • Mullany K, Minneci M, Monjazeb R, C Coiado O. Overview of ectopic pregnancy diagnosis, management, and innovation. Womens Health (Lond). 2023;19:17455057231160349. https://doi.org/10.1177/17455057231160349
  • Hendriks E, Rosenberg R, Prine L. Ectopic Pregnancy: Diagnosis and Management. Am Fam Physician. 2020;101(10):599-606.
  • Akdaş Reis Y, Özkan M, Yılmaz Ergani S, et al. Latest trend ectopic pregnancy management in a tertiary health center: a retrospective cohort study. Perinatal Journal. 2022;30(3):308-13. https://doi.org/10.2399/prn.22.0303013
  • Xiao C, Shi Q, Cheng Q, Xu J. Non-surgical management of tubal ectopic pregnancy: A systematic review and meta-analysis. Medicine (Baltimore). 2021;100(50):e27851. https://doi.org/10.1097/MD.0000000000027851
  • Lipscomb GH, Givens VA, Meyer NL, Bran D. Previous ectopic pregnancy as a predictor of failure of systemic methotrexate therapy. Fertil Steril. 2004;81(5):1221-4. https://doi.org/10.1016/j.fertnstert.2003.09.070
  • Khalil A, Saber A, Aljohani K, Khan M. The Efficacy and Success Rate of Methotrexate in the Management of Ectopic Pregnancy. Cureus. 2022;14(7):e26737. https://doi.org/10.7759/cureus.26737
  • Karadeniz RS, Tasci Y, Altay M, Akkuş M, Akkurt O, Gelişen O. Tubal rupture in ectopic pregnancy: is it predictable? Minerva Ginecol. 2015;67(1):13-9.
  • Karadeniz RS, Dilbaz S, Özkan SD. Unilateral twin tubal pregnancy successfully treated with methotrexate. Int J Gynaecol Obstet. 2008;102(2):171. https://doi.org/10.1016/j.ijgo.2008.03.012
There are 9 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Case Report
Authors

Zeliha Nur Ergül 0009-0001-7601-7015

Rahmi Sinan Karadeniz 0000-0003-4994-9658

Publication Date June 9, 2024
Submission Date April 24, 2024
Acceptance Date May 16, 2024
Published in Issue Year 2024

Cite

APA Ergül, Z. N., & Karadeniz, R. S. (2024). Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, 6(2), 73-76. https://doi.org/10.46969/EZH.1472903
AMA Ergül ZN, Karadeniz RS. Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report. Türk Kadın Sağlığı ve Neonatoloji Dergisi. June 2024;6(2):73-76. doi:10.46969/EZH.1472903
Chicago Ergül, Zeliha Nur, and Rahmi Sinan Karadeniz. “Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi 6, no. 2 (June 2024): 73-76. https://doi.org/10.46969/EZH.1472903.
EndNote Ergül ZN, Karadeniz RS (June 1, 2024) Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report. Türk Kadın Sağlığı ve Neonatoloji Dergisi 6 2 73–76.
IEEE Z. N. Ergül and R. S. Karadeniz, “Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report”, Türk Kadın Sağlığı ve Neonatoloji Dergisi, vol. 6, no. 2, pp. 73–76, 2024, doi: 10.46969/EZH.1472903.
ISNAD Ergül, Zeliha Nur - Karadeniz, Rahmi Sinan. “Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report”. Türk Kadın Sağlığı ve Neonatoloji Dergisi 6/2 (June 2024), 73-76. https://doi.org/10.46969/EZH.1472903.
JAMA Ergül ZN, Karadeniz RS. Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2024;6:73–76.
MLA Ergül, Zeliha Nur and Rahmi Sinan Karadeniz. “Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, vol. 6, no. 2, 2024, pp. 73-76, doi:10.46969/EZH.1472903.
Vancouver Ergül ZN, Karadeniz RS. Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2024;6(2):73-6.