Oral communication abstractsfailed PUL if the predicted risk of a failed PUL was at least 95%, and predicted IUP analogously. All other PUL are considered at risk of being ectopic. Results: Of the 375 PUL the final outcome was: 48 (13%) EP, 246 (66%) FPUL, and finally 81 (22%) an IUP. Using the first model, the predicted outcome was correct in 99% of the FPUL, 100% of IUP and in 22% of the EPs with an AUC of 0.96, 0.95 and 0.80 respectively. The performance of the second model including timing as a variable showed no significant difference in performance with 99% of the FPUL, 0% of IUP (0 predicted cases) and 22% of EPs with an AUC of 0.97, 0.95 and 0.77 respectively. Approximately 75% of the cases had their repeat hCG within 30 minutes from the 48 hours interval. Conclusions: Including timings of hCG assays does not improve models used to predict the outcome of PUL. This suggests that the hours between hCG samples is not critical. Both models can successfully select women at low risk of EP and choose appropriate follow up. Clinically women can be given significant flexibility when returning for a second sample. The data support exploring using shorter time intervals for the hCG ratio such as 24 hours which may lead to triage of PUL at an earlier stage.
OC07.02The efficacy and safety of ultrasound-guided methotrexate treatment in Caesarean scar pregnancy Chinese PLA General Hospital, Beijing, China Objectives: To investigate the efficacy and safety of Ultrasound-guide methotrexate (MTX) injection in treating Caesarean scar pregnancy (CSP). Methods: 30 cases of CSP were given ultrasound-guided MTX injection treatment from December 2007 to January 2011. Among them 5 cases (4 had abortion and D&C) had each a mass in the scar (mass type) and 25 cases had each a gestational sac partially or totally embedded in the scar (GS type). One of them had profuse vaginal bleeding before treatment while one had medical abortion but failed. Guided by ultrasound amniotic fluid was drawn out from the sac and 50 ∼ 60 mg of MTX injected into the gestational sac in 25 cases. In another 5 cases, 50-75 mg of MTX was injected into the area with Color Doppler blood signal within the mass. β-HCG level was tested before treatment and then once a week afterwards until it become normal. Results: 30 patients received 35 ultrasound-guided MTX injection treatments. 4 patients received a second course of MTX because of persistent Color Doppler blood signal at the site of CSP and too slow declining of β-HCG level. One patient received uterine artery embolization (UAE) owing to profuse vaginal bleeding and a second course of MTX injection. One patient had hysteroscopy under surveillance of laparoscopy owing to a sharp increase of β-HCG (15000 U/L to 75645 U/L in one week). The patient with previous vaginal bleeding had profuse vaginal bleeding received UAE in 4 days, laparotomy and D&C 8 days later. 23 cases received no further treatment. One week after treatment β-HCG value increased in 11 cases (all in GS group) with a range from 57 U/L ∼ 60...
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