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Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case

Yıl 2011, Cilt: 2011 Sayı: 1, 10 - 13, 01.01.2011
https://doi.org/10.5174/tutfd.2009.02161.1

Öz

Objective: To evaluate the efficacy of single dose intramuscular methotrexate in the treatment of ectopic pregnancy. Material and Methods: 32 patients who matched the inclusion criteria were enrolled. Success of treatment was defined as a resolution of ectopic pregnancy without performing surgical intervention. The cases in whom the treatment was successful and those that were not were compared for β-hCG values and clinical features. Results: β-hCG at diagnosis averaged 1293.9 mIU/ml. Of the 32 patients who received methotrexate, 26 were successfully treated. 23 patients (71.8%) received a single dose of methotrexate, 3 patients (9.3%) received an additional dose of methotrexate, 6 patients (18.7%) who had failed methotrexate required surgery for cure. The success rate of single-dose methotrexate was 79.3%. Conclusion: Our study shows that single dose systemic methotrexate treatment can be used as an option in unruptured pregnancies.

Kaynakça

  • Tay JI, Moore J, Walker JJ. Ectopic Pregnancy: British Medical Journal 2000;320:916-9.
  • Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ec- topic pregnancy. New Eng J Med. 2000;343:1325-9.
  • Lipscomb GH, Bran D, Ling FW. Analysis of three hundred fifteen ectopic pregnancies treated with single dose Methotrexate. Am J Obstet Gynecol 1998;78:1354-8.
  • Stovall TG, Ling FW and Gray LA. Single-dose methotrexate for treatment of ectopic pregnancy. Obstet Gynecol 1991;77:754-7.
  • Glock JL, Johnson JV, Brumsted JR. Efficacy and safety of single- dose methotrexate in the treatment of ectopic pregnancy. Fertil Steril 1994;62:716-21.
  • Buster JE, Pisarska MD. Medical management of ectopic preg- nancy. Clin Obstet Gynecol 1999;42:23-30.
  • Dudley PS, Heard MJ, Sangi-Haghpeykar H, Carson SA, Buster JE. Characterizing ectopic pregnancies that rupture despite treatment with methotrexate. Fertil Steril 2004;82:1374-8.
  • Lispcomb GH, Givens VA, Meyer NL, Bran D. Previous ectopic pregnancy as a predictor of failure of systemic methotrexate therapy. Fertil Steril 2004;81:1221-4.
  • Takacs P, Rodriguez L. High folic acid levels and failure of single- dose methotrexate treatment in ectopic pregnancy. Int J Gynae- col Obstet 2005;89:301-2.
  • Takacs P, Chakhtoura N, De Santis T, Verma U. Evaluation of the relationship between endometrial thickness and failure of single- dose methotrexate in ectopic pregnancy. Arch Gynecol Obstet 2005;272:269-72.
  • Bixby S, Tello R, Kuligowska E. Presence of a yolk sac on trans- vaginal sonography is the most reliable predictor of single-dose methotrexate treatment failure in ectopic pregnancy. J Ultra- sound Med 2005;24:591-8.
  • Gabbur N, Sherer DM, Hellmann M, Abdelmalek E, Phillip P, Abu- lafia O. Do serum beta-human chorionic gonadotrophin levels on day 4 following methotrexate treatment of patients with ectopic pregnancy predict successful single-dose therapy? Am J Perina- tol 2006;23:193-6.
  • Nowak-Markwitz E, Michalak M, Olejnik M, Spaczynski M. Cutoff value of human chorionic gonadotropin in relation to the num- ber of methotrexate cycles in the successful treatment of ectopic pregnancy. Fertil Steril. 2008;92:1203-7.
  • da Costa Soares R, Elito J Jr, Camano L. Increment in beta-hCG in the 48-h period prior to treatment: a new variable predictive of therapeutic success in the treatment of ectopic pregnancy with methotrexate. Arch Gynecol Obstet. 2008;278:319-24.
  • Barnhart KT, Gosman G, Ashby R, Sammel M. The medical man- agement of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynecol 2003;101:778-84.
  • van Mello NM, Mol F, Mol BW, Hajenius PJ. Conservative man- agement of tubal ectopic pregnancy. Best Pract Res Clin Obstet Gynaecol. 2009;23:509-18.
  • Lipscomb GH, Gomez IG, Givens VM, Meyer NL, Bran DF. Yolk sac on transvaginal ultrasound as a prognostic indicator in the treatment of ectopic pregnancy with single-dose methotrexate. Am J Obstet Gynecol. 2009;200:1-4.
  • Moon MH, Lee YH, Lim KT, Yang JH, Park SH. Outcome predic- tion for treatment of tubal pregnancy using an intramuscular methotrexate protocol. J Ultrasound Med. 2008;27:1461-7.

Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case

Yıl 2011, Cilt: 2011 Sayı: 1, 10 - 13, 01.01.2011
https://doi.org/10.5174/tutfd.2009.02161.1

Öz

Kaynakça

  • Tay JI, Moore J, Walker JJ. Ectopic Pregnancy: British Medical Journal 2000;320:916-9.
  • Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ec- topic pregnancy. New Eng J Med. 2000;343:1325-9.
  • Lipscomb GH, Bran D, Ling FW. Analysis of three hundred fifteen ectopic pregnancies treated with single dose Methotrexate. Am J Obstet Gynecol 1998;78:1354-8.
  • Stovall TG, Ling FW and Gray LA. Single-dose methotrexate for treatment of ectopic pregnancy. Obstet Gynecol 1991;77:754-7.
  • Glock JL, Johnson JV, Brumsted JR. Efficacy and safety of single- dose methotrexate in the treatment of ectopic pregnancy. Fertil Steril 1994;62:716-21.
  • Buster JE, Pisarska MD. Medical management of ectopic preg- nancy. Clin Obstet Gynecol 1999;42:23-30.
  • Dudley PS, Heard MJ, Sangi-Haghpeykar H, Carson SA, Buster JE. Characterizing ectopic pregnancies that rupture despite treatment with methotrexate. Fertil Steril 2004;82:1374-8.
  • Lispcomb GH, Givens VA, Meyer NL, Bran D. Previous ectopic pregnancy as a predictor of failure of systemic methotrexate therapy. Fertil Steril 2004;81:1221-4.
  • Takacs P, Rodriguez L. High folic acid levels and failure of single- dose methotrexate treatment in ectopic pregnancy. Int J Gynae- col Obstet 2005;89:301-2.
  • Takacs P, Chakhtoura N, De Santis T, Verma U. Evaluation of the relationship between endometrial thickness and failure of single- dose methotrexate in ectopic pregnancy. Arch Gynecol Obstet 2005;272:269-72.
  • Bixby S, Tello R, Kuligowska E. Presence of a yolk sac on trans- vaginal sonography is the most reliable predictor of single-dose methotrexate treatment failure in ectopic pregnancy. J Ultra- sound Med 2005;24:591-8.
  • Gabbur N, Sherer DM, Hellmann M, Abdelmalek E, Phillip P, Abu- lafia O. Do serum beta-human chorionic gonadotrophin levels on day 4 following methotrexate treatment of patients with ectopic pregnancy predict successful single-dose therapy? Am J Perina- tol 2006;23:193-6.
  • Nowak-Markwitz E, Michalak M, Olejnik M, Spaczynski M. Cutoff value of human chorionic gonadotropin in relation to the num- ber of methotrexate cycles in the successful treatment of ectopic pregnancy. Fertil Steril. 2008;92:1203-7.
  • da Costa Soares R, Elito J Jr, Camano L. Increment in beta-hCG in the 48-h period prior to treatment: a new variable predictive of therapeutic success in the treatment of ectopic pregnancy with methotrexate. Arch Gynecol Obstet. 2008;278:319-24.
  • Barnhart KT, Gosman G, Ashby R, Sammel M. The medical man- agement of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynecol 2003;101:778-84.
  • van Mello NM, Mol F, Mol BW, Hajenius PJ. Conservative man- agement of tubal ectopic pregnancy. Best Pract Res Clin Obstet Gynaecol. 2009;23:509-18.
  • Lipscomb GH, Gomez IG, Givens VM, Meyer NL, Bran DF. Yolk sac on transvaginal ultrasound as a prognostic indicator in the treatment of ectopic pregnancy with single-dose methotrexate. Am J Obstet Gynecol. 2009;200:1-4.
  • Moon MH, Lee YH, Lim KT, Yang JH, Park SH. Outcome predic- tion for treatment of tubal pregnancy using an intramuscular methotrexate protocol. J Ultrasound Med. 2008;27:1461-7.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Aysun Aybatlı Bu kişi benim

Petek Balkanlı Kaptan Bu kişi benim

Niyazi Cenk Sayın Bu kişi benim

Mehmet Alicik Bu kişi benim

Mehmet Ali Yüce Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2011
Yayımlandığı Sayı Yıl 2011 Cilt: 2011 Sayı: 1

Kaynak Göster

APA Aybatlı, A., Kaptan, P. B., Sayın, N. C., Alicik, M., vd. (2011). Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case. Balkan Medical Journal, 2011(1), 10-13. https://doi.org/10.5174/tutfd.2009.02161.1
AMA Aybatlı A, Kaptan PB, Sayın NC, Alicik M, Yüce MA. Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case. Balkan Medical Journal. Ocak 2011;2011(1):10-13. doi:10.5174/tutfd.2009.02161.1
Chicago Aybatlı, Aysun, Petek Balkanlı Kaptan, Niyazi Cenk Sayın, Mehmet Alicik, ve Mehmet Ali Yüce. “Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case”. Balkan Medical Journal 2011, sy. 1 (Ocak 2011): 10-13. https://doi.org/10.5174/tutfd.2009.02161.1.
EndNote Aybatlı A, Kaptan PB, Sayın NC, Alicik M, Yüce MA (01 Ocak 2011) Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case. Balkan Medical Journal 2011 1 10–13.
IEEE A. Aybatlı, P. B. Kaptan, N. C. Sayın, M. Alicik, ve M. A. Yüce, “Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case”, Balkan Medical Journal, c. 2011, sy. 1, ss. 10–13, 2011, doi: 10.5174/tutfd.2009.02161.1.
ISNAD Aybatlı, Aysun vd. “Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case”. Balkan Medical Journal 2011/1 (Ocak 2011), 10-13. https://doi.org/10.5174/tutfd.2009.02161.1.
JAMA Aybatlı A, Kaptan PB, Sayın NC, Alicik M, Yüce MA. Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case. Balkan Medical Journal. 2011;2011:10–13.
MLA Aybatlı, Aysun vd. “Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case”. Balkan Medical Journal, c. 2011, sy. 1, 2011, ss. 10-13, doi:10.5174/tutfd.2009.02161.1.
Vancouver Aybatlı A, Kaptan PB, Sayın NC, Alicik M, Yüce MA. Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case. Balkan Medical Journal. 2011;2011(1):10-3.