A prospective series of unruptured ectopic pregnancies treated by tubal injection with hyperosmolar glucose

Yeko, Timothy R.; Mayer, James C.; Parsons, Anna K.; Maroulis, George

doi:10.1016/0029-7844(94)00347-g

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…The reported incidence in 1993 ranged from 1/80-1/200 live births [19]. The steady increase of ectopic pregnancy in the USA, as well as in several European countries during the past 25 years, could be attributed to an increased incidence of salpingitis, a major risk, as well as improved diagnostic techniques [20]. In this study, the incidence of ectopic pregnancy is lower than that of developing countries being nearly similar to the incidence of developed countries 20 years back.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital

Aj¹,

Dikrayat²

2017

Crit Care Obst & Gyne

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Objective: To determine the frequency of tubal ectopic pregnancy and to evaluate the epidemiological and common predisposing factors in cases study. To determine the mode of management of tubal ectopic pregnancy.Study Design: This is a prospective descriptive analytic study carried out from 1 January 2013 until 31 December 2013 at obstetric and gynecological unit at Al-Thawra Hospital in Sana'a, Yemen.Results: Total number of deliveries from the 1st of January 2013 till the 31st of December 2013, were a total of 9330 deliveries, out of which 103 women had tubal ectopic pregnancy creating an incidence of 1.1% of the total deliveries with a ratio of 11/1000 live births. The mean age of the patients was 27.8 yrs and ranged between 17-40 years of age. It was most common in multipara with a percentage of 78.67 54.4% of women were Qat chewers and smokers. It was more commonly found in women of low economic status with 90.3%. 30.1% of women with it had a history of abortion, 70.9% had a history of pelvic inflammatory disease, 20.8% had a history of an abdominopelvic surgery, 11.7% were using intrauterine device and 5.8% were using progesterone-only pills, 1.9% had a history of tubal sterilization, 88.3% presented with abdominal pain, 72.8% gave a history of amenorrhea, 63.1% presented with vaginal bleeding, 79.6% presented with hemodynamic instability, 86.5% were treated surgically, and 14.5% were treated medically using Methotrexate. The surgical treatment was salpingectomy in 90.4%, and 6.6% was salpingostomy. There were no maternal mortalities. Conclusion:The most common risk factors found in patients with tubal ectopic pregnancy were previous abortions and PID. The majority of the patients were treated surgically as they were lately presented in a state of hemodynamic instability. 14.5% were treated medically and this proved to be very effective.

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Section: Discussionmentioning

confidence: 99%

Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital

Aj¹,

Dikrayat²

2017

Crit Care Obst & Gyne

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“…Indeed, in a prospective study comparing TVUS to laparoscopic-guided injection of tubal pregnancies with hypertonic glucose, six of the 41 (15%) women in the laparoscopic guidance group could not have their tube accessed via that route. 16 Yeko et al 20 reported that, of 16 women prospectively entered into a laparoscopic-guided hyperosmolar glucose study, nine needed lysis of adhesions, increasing the duration of surgery. In a similar fashion, a patient with a high body mass index (BMI) may also be technically easier to treat via a transvaginal approach.…”

Section: Methodsmentioning

confidence: 99%

Local Treatment of Ectopic Pregnancy

Raughley

Frishman²

2007

Semin Reprod Med

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The treatment of ectopic pregnancies has evolved from a purely surgical route with routine removal of the fallopian tube to one with multiple options. Medical treatment can be administered systemically or via local injection. Local delivery of chemotherapeutic agents is a safe and proven modality that is especially indicated for pregnancies in which a laparoscopic approach is not ideal and systemic therapy either has failed or is not desired. Local therapy has the potential to document immediately the cessation of fetal heart activity. Nontubal ectopic pregnancies may be ideally suited to local therapy, especially when there is a fetal heart present. Transvaginal ultrasound is the preferred mode for guidance and laparoscopic guidance has a limited role. Although a multitude of agents have been proposed, methotrexate, KCl, and hyperosmolar glucose are the most widely used and readily available. Local therapy has an important place in the armamentarium of the treatment of ectopic pregnancies.

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“…Different methods of conservative treatment of ectopic pregnancies have been adopted [4][5][6][7][8][9][10]. Parenteral administration of MTX had a success rate of about 95% [4].…”

Section: Discussionmentioning

confidence: 99%

Local Application of Methotrexate for Ectopic Pregnancy with a Percutaneous Puncturing Technique

Mesogitis¹,

Antsaklis²,

Papantoniou³

et al. 1998

Gynecol Obstet Invest

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Management of ectopic pregnancy remains traditionally surgical. Early detection of unruptured ectopic pregnancies, using both ultrasound techniques and β-human chorionic gonadotropin (β-hCG) assays, allows a more conservative treatment. Twenty-six tubal pregnancies, which were managed with local methotrexate (MTX) injection, are presented. A single dose of 10–12.5 mg of MTX was percutaneously injected into the gestational sac under abdominal sonographic control. Complete resolution was obtained in all our patients. Four of them required a second percutaneous administration 4 days after the first one. Negligible serum β-hCG levels (<10 mIU/ml) were reached within 42 days after treatment. No systemic side effects were observed. Local administration of MTX under abdominal sonographic control seems to be an effective alternative for the treatment of ectopic pregnancy. The main potential advantages of the method are (1) a greater antitrophoblastic effect; (2) a shorter treatment period; (3) reduced dosage, and (4) absence of side effects.

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A prospective series of unruptured ectopic pregnancies treated by tubal injection with hyperosmolar glucose

Abstract: Laparoscopic injection with hyperosmolar glucose is an effective, systemically nontoxic alternative treatment for select unruptured ectopic pregnancies (hCG less than 2500 mIU/mL) that achieves tubal patency rates comparable to other conservative medical and surgical treatments.

Cited by 11 publications

References 10 publications

Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital

Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital

Local Treatment of Ectopic Pregnancy

Local Application of Methotrexate for Ectopic Pregnancy with a Percutaneous Puncturing Technique

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