BibTex RIS Kaynak Göster

Tubal passage control after methotrexate treatment in ectopic pregnancies

Yıl 2011, , 400 - 403, 01.12.2011
https://doi.org/10.5799/ahinjs.01.2011.04.0080

Öz

Objectives: In this study, it was aimed to evaluate the results of ipsilateral tubal passage control in the cases treated with methotrexate (MTX). Materials and methods: Totally 30 patients aged between 21 and 40 years who have received single dose MTX treatment due to ectopic pregnancy was included. All patients were as hemodynamically stabile. Serum beta human chorionic gonadotropin (BhCG) levels and ultrasonographic findings prior to the MTX treatment were recorded. Patients were re-evaluated 6 months after serum BhCG levels became negative for the outcome of treatment. Results: The mean age of the 30 cases was 30.6±4.4 years. The BhCG levels of the cases was changing between 160 and 10910, their average is 2387±2499 IU/L. The MTX dose was changing between 50 to 100 mg, with average of 67.7±13.5 mg. Four (13.3%) of the cases received additional dose of MTX. Laparotomy was performed in 3 (10%) cases due to tubal rupture developing during the treatment. Among 27 cases on whom the tubal passage control is made 6 months after the treatment, tubal passage was found to be open in 22 (81.5%) of the cases and closed in 5 (18.5%). There was no significant difference between the BhCG levels of cases with open and closed tubal passage (p>0.05). Conclusion: The medical treatment to be applied on non-ruptured ectopic pregnancies has many advantages. Less tubal damage occurs by the medical treatment, it decreases the morbidity for anesthesia and surgery. J Clin Exp Invest 2011; 2 (4): 400-403

Kaynakça

  • Ory SJ. New options for diagnosis and treatment of ectopic pregnancy. JAMA 1999;267(4):534-7.
  • Damario MA,Rock JA. Ectopic Pregnancy.In Rock JA Jones HW eds, Operative Gynecology Te Linde’s, Ninth edition. Lippincout Williams&Wilkins 2003,507- 33.
  • Torp VA. Therapeutic options for ectopic pregnancy. West J Med 1992; 156(6): 651-2.
  • Stovall TG, Ling FW, Andersen RN, Buster JE. Improved sensitivitiy and specificitiy of a single measurement of serum progesteron over serial quantitavite beta-hu- man chorionic gonadotrophin in screening for ectopic pregnancy. Hum Reprod 1992;7(5):723-5.
  • James R, Philip J, Diasa S. Extrauterine findings of ec- topic pregnancy at transvaginal sonography. Obstetr Gynecol 1994;118(1):133-40.
  • Gabrielli S, Romero R, Pilu G, Bovicelli L. Accuracy of transvajinal ultrasound and serum HCG in the diagno- sis of ectopic pregnancy. Ultrasound Obstet Gynecol 1992;2(2):110-5.
  • Stovall TG, Ling FW, Buster JE. Outpatient chemo- therapy of unruptured ectopic pregnancy. Fertil Steril 1989; 51(3):435-8.
  • Hajenius PJ, Ankum WB, Hemrika DJ, Lammes FB. Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy. Lan- cet 1997; 350(9):774-6.
  • Elito JJ, Han KK, Camano L. Values of beta-human chorionic gonadotropin a risk factor for tubal obstruc- tion after tubal pregnancy. Acta Obstet Gynecol Scand 2005; 84(9): 864-7.

Tubal passage control after methotrexate treatment in ectopic pregnancies

Yıl 2011, , 400 - 403, 01.12.2011
https://doi.org/10.5799/ahinjs.01.2011.04.0080

Öz

Amaç: Bu çalışmada metotreksat (MTX) ile tedavi olmuş ektopik gebelik olgularında ipsilateral tubal pasaj kontrolü yapılarak sonuçların değerlendirilmesi amaçlandı. Gereç ve yöntem: Çalışmaya ektopik gebelik nedeniyle tek doz MTX tedavisi almış yaşları 21 ile 40 arasında değişmekte olan 30 hasta dahil edildi. Hastaların tümü hemodinamik olarak stabildi. MTX tedavisine başlamadan önceki serum beta human chorionic gonadotropin (BhCG) seviyeleri, ultrasonografi bulguları kaydedildi. Serum BhCG düzeyleri negatif olduktan 6 ay sonra tubal pasaj kontrolü yapılan hastalar tedavi sonuçları ile tekrar değerlendirildi. Bulgular: Çalışmaya alınan 30 olgunun yaş ortalaması 30.6±4.4 yıl idi. Olguların BhCG düzeyleri 160 ile 10910 IU/L arasında değişmekte olup, ortalaması 2387±2499 IU/L idi. Kullandıkları MTX dozları 50 mg ile 100 mg arasında değişmekte olup, ortalaması 67.7±13.5 mg idi. Olguların 4\'üne (%13.3) ek doz MTX uygulandı. Olguların 3\'üne (%10) tedavi sırasında gelişen tubal rüptür nedeniyle laparotomi yapıldı. Tedaviden 6 ay sonra tubal pasaj kontrolü yapılan 27 olgunun, 22\'sinin (%81.5) tubal pasajı açık, 5\'inin (%18.5) kapalı bulundu. Tubal pasajı açık olan olgular ile kapalı olan olguların BhCG düzeyleri arasında istatistiksel olarak anlamlı bir farklılık bulunmadı (p>0.05). Sonuç: Rüptüre olmamış ektopik gebeliklerde uygulanacak medikal tedavi ile daha az tubal hasar meydana gelmekte, anesteziye ve cerrahiye ait morbidite azaltmaktadır.

Kaynakça

  • Ory SJ. New options for diagnosis and treatment of ectopic pregnancy. JAMA 1999;267(4):534-7.
  • Damario MA,Rock JA. Ectopic Pregnancy.In Rock JA Jones HW eds, Operative Gynecology Te Linde’s, Ninth edition. Lippincout Williams&Wilkins 2003,507- 33.
  • Torp VA. Therapeutic options for ectopic pregnancy. West J Med 1992; 156(6): 651-2.
  • Stovall TG, Ling FW, Andersen RN, Buster JE. Improved sensitivitiy and specificitiy of a single measurement of serum progesteron over serial quantitavite beta-hu- man chorionic gonadotrophin in screening for ectopic pregnancy. Hum Reprod 1992;7(5):723-5.
  • James R, Philip J, Diasa S. Extrauterine findings of ec- topic pregnancy at transvaginal sonography. Obstetr Gynecol 1994;118(1):133-40.
  • Gabrielli S, Romero R, Pilu G, Bovicelli L. Accuracy of transvajinal ultrasound and serum HCG in the diagno- sis of ectopic pregnancy. Ultrasound Obstet Gynecol 1992;2(2):110-5.
  • Stovall TG, Ling FW, Buster JE. Outpatient chemo- therapy of unruptured ectopic pregnancy. Fertil Steril 1989; 51(3):435-8.
  • Hajenius PJ, Ankum WB, Hemrika DJ, Lammes FB. Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy. Lan- cet 1997; 350(9):774-6.
  • Elito JJ, Han KK, Camano L. Values of beta-human chorionic gonadotropin a risk factor for tubal obstruc- tion after tubal pregnancy. Acta Obstet Gynecol Scand 2005; 84(9): 864-7.
Toplam 9 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Yazısı
Yazarlar

Neval Yaman Görük Bu kişi benim

Abdulkadir Turgut Bu kişi benim

Senem Yaman Tunç Bu kişi benim

Necdet Süer Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2011
Yayımlandığı Sayı Yıl 2011

Kaynak Göster

APA Görük, N. Y., Turgut, A., Tunç, S. Y., Süer, N. (2011). Tubal passage control after methotrexate treatment in ectopic pregnancies. Journal of Clinical and Experimental Investigations, 2(4), 400-403. https://doi.org/10.5799/ahinjs.01.2011.04.0080
AMA Görük NY, Turgut A, Tunç SY, Süer N. Tubal passage control after methotrexate treatment in ectopic pregnancies. J Clin Exp Invest. Aralık 2011;2(4):400-403. doi:10.5799/ahinjs.01.2011.04.0080
Chicago Görük, Neval Yaman, Abdulkadir Turgut, Senem Yaman Tunç, ve Necdet Süer. “Tubal Passage Control After Methotrexate Treatment in Ectopic Pregnancies”. Journal of Clinical and Experimental Investigations 2, sy. 4 (Aralık 2011): 400-403. https://doi.org/10.5799/ahinjs.01.2011.04.0080.
EndNote Görük NY, Turgut A, Tunç SY, Süer N (01 Aralık 2011) Tubal passage control after methotrexate treatment in ectopic pregnancies. Journal of Clinical and Experimental Investigations 2 4 400–403.
IEEE N. Y. Görük, A. Turgut, S. Y. Tunç, ve N. Süer, “Tubal passage control after methotrexate treatment in ectopic pregnancies”, J Clin Exp Invest, c. 2, sy. 4, ss. 400–403, 2011, doi: 10.5799/ahinjs.01.2011.04.0080.
ISNAD Görük, Neval Yaman vd. “Tubal Passage Control After Methotrexate Treatment in Ectopic Pregnancies”. Journal of Clinical and Experimental Investigations 2/4 (Aralık 2011), 400-403. https://doi.org/10.5799/ahinjs.01.2011.04.0080.
JAMA Görük NY, Turgut A, Tunç SY, Süer N. Tubal passage control after methotrexate treatment in ectopic pregnancies. J Clin Exp Invest. 2011;2:400–403.
MLA Görük, Neval Yaman vd. “Tubal Passage Control After Methotrexate Treatment in Ectopic Pregnancies”. Journal of Clinical and Experimental Investigations, c. 2, sy. 4, 2011, ss. 400-3, doi:10.5799/ahinjs.01.2011.04.0080.
Vancouver Görük NY, Turgut A, Tunç SY, Süer N. Tubal passage control after methotrexate treatment in ectopic pregnancies. J Clin Exp Invest. 2011;2(4):400-3.