Alternative to surgery of treatment of unruptured interstitial pregnancy: 15 cases of medical treatment

Bénifla, Jean-Louis; Fernandez, H.; Sebban, E; Daraı̈, Émile; Frydman, René; Madelenat, P.

doi:10.1016/s0301-2115(95)02589-8

Cited by 95 publications

(63 citation statements)

References 25 publications

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“…It has been documented that sonographically guided local drug injections can be used for patients with serum β-hCG levels lower than 5000 mIU/mL, an ectopic mass diameter smaller than 4.0 cm, and no active bleeding; however, local drug injections may decrease the success rate for patients with serum β-hCG levels of 15,000 mIU/mL or higher. 15,[37][38][39][40] Of all 26 patients given local multiple-drug injection, 17 had serum β-hCG levels higher than 5,000 mIU/mL, with 35,670 mIU/mL as the highest value shown. Twelve patients had an ectopic mass diameter of 4.0 cm or larger, with a maximum value of 5.1 cm.…”

Section: Dai Et Al-multiple-drug Injection Treatment In Unruptured Ecmentioning

confidence: 99%

Clinical Effectiveness of Multiple-Drug Injection Treatment in Unruptured Ectopic Pregnancies

Dai

Wang

Shao

et al. 2012

Journal of Ultrasound in Medicine

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A Retrospective Studyn ectopic pregnancy is a common cause of acute abdomen in the obstetrics and gynecology department. Once an ectopic pregnancy has ruptured and begins bleeding, it can seriously endanger the life of the woman, with a mortality rate approaching 10%. 1,2 In recent years, with the application of transvaginal color Doppler sonography, the diagnosis rate of unruptured ectopic pregnancies has improved substantially, providing a reliable basis for selection and timing of treatment options. 3,4 Quan Dai, MM, Lu-Lu Wang, MM, Xiao-Hui Shao, MM, Si-Ming Wang, MM, Xiao-Qiu Dong, MD Received December 2, 2011, Methods-In this retrospective analysis, 49 patients with an unruptured ectopic pregnancy were treated with two different local injection methods administered under sonographic guidance. The patients were divided into single-drug (n = 23) and multiple-drug (n = 26) injection groups, and they received a locally administered injection of methotrexate alone or a combination including methotrexate, hemocoagulase, antibiotics, and anti-inflammatory drugs, respectively. Overall, local injection treatment was successful in 44 patients. The 5 patients with failed treatment underwent laparotomy about 1 week after single-drug injection. Serum β-human chorionic gonadotropin (β-hCG ) levels, ectopic pregnancy mass sizes, blood flow at various points after treatment, the incidence of pelvic bleeding, and the time for serum β-hCG levels to return to normal and the mass to resolve were analyzed in the remaining 44 patients.Results-Single-drug treatment was successful in 18 patients; 10 of 23 had low to moderate pelvic bleeding after treatment, and 5 were referred for surgery. All 26 patients were successfully treated by multiple-drug injection. Only 2 patients had a small amount of pelvic bleeding. Differences between groups were statistically significant (P < .05) for surgery rates, the incidence of pelvic bleeding, transient increases in serum β-hCG levels, mean days to normal β-hCG levels, mean days of mass resolution, and mean mass diameters 1 to 6 weeks after treatment.Conclusions-Local multiple-drug injection under color Doppler guidance is a new, safe, and effective method for treating unruptured ectopic pregnancies. It accelerates the serum β-hCG decline and facilitates mass resolution. This regimen is associated with a very low rate of pelvic bleeding, improves the success rate of conservative treatment, and, therefore, has value as an important clinical application.

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Section: Dai Et Al-multiple-drug Injection Treatment In Unruptured Ecmentioning

confidence: 99%

Clinical Effectiveness of Multiple-Drug Injection Treatment in Unruptured Ectopic Pregnancies

Dai

Wang

Shao

et al. 2012

Journal of Ultrasound in Medicine

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show abstract

“…(Timor-Tritsch IE, 1997;Benifla JL et al, 1996;Onderoglu LS et al, 2006) Either of these treatment options aimed to reduce the systemic exposure and side effects of Methotrexate with a chance of spontaneous resolution of ectopics in some studies can be as high as 100%. (Monteagudo A et al, 2005) Local potassium chloride injection has been used as alternative to Local Methotrexate with promising results.…”

Section: Local Methotrexatementioning

confidence: 99%

Modern Management of Cornual Ectopic Pregnancy

Shendy¹,

Atalla²

2011

Ectopic Pregnancy - Modern Diagnosis and Management

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“…A further consideration is that the appropriate dose of local MTX is yet to be determined. Several doses of MTX have been described (Benifla et al, 1996;Sagiv et al, 2001;Lin et al, 2007). The most used is a dose of 1 mg/kg body weight and this is the dose selected for the study (Fernandez et al, 1993)).…”

Section: Selection Criteriamentioning

confidence: 99%

Clinical Treatment of Unruptured Ectopic Pregnancy

Elito¹

2011

Ectopic Pregnancy - Modern Diagnosis and Management

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Alternative to surgery of treatment of unruptured interstitial pregnancy: 15 cases of medical treatment

Cited by 95 publications

References 25 publications

Clinical Effectiveness of Multiple-Drug Injection Treatment in Unruptured Ectopic Pregnancies

Clinical Effectiveness of Multiple-Drug Injection Treatment in Unruptured Ectopic Pregnancies

Modern Management of Cornual Ectopic Pregnancy

Clinical Treatment of Unruptured Ectopic Pregnancy

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