Diagnosis and Management of Ectopic Pregnancy

doi:10.1111/1471-0528.14189

Cited by 229 publications

(162 citation statements)

References 174 publications

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“…In a similar study by Kutuk et. al., no significant differences in MTHFR polymorphism frequencies were reported between 21 MTXunresponsive and 88 responsive patients [11]. They also obtained paternal blood samples to infer fetal genotype and did not found any association either.…”

Section: Discussionmentioning

confidence: 90%

“…For similar future MTHFR polymorphism studies in ectopic pregnancies, paternal screening along with maternal screening would be valuable. Moreover, serum folate, homocysteine and vitamin B12 level measurements in a much larger population treated and not treated with MTX might add significant implications [11,[25][26][27]…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we aimed to investigate the possible association between common MTHFR polymorphisms (A1298 and C677T) and MTX treatment failure in patients with tubal pregnancies. Recently, this relation was not found on the blood samples of tubal ectopic pregnancies that have been treated with MTX [11]. In the present study, we focused on trophoblasts, rather than maternal blood samples in order to delineate possible fetal polymorphism effect.…”

Section: Introductionmentioning

confidence: 91%

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Common Methylenetetrahydrofolate Reductase Polymorphisms (A1298C & C677T) in Ectopic Trophoblasts and Methotrexate Treatment Failure in Tubal Pregnancies

et al. 2018

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Objectives: The success rate of methotrexate (MTX) therapy varies among tubal ectopic pregnancies. Common methylenetetrahydrofolate reductase (MTHFR) polymorphisms (C677T&A1298C) have been suggested to alter MTX effect. This study aimed to assess and compare MTX treatment failure rates with respect to MTHFR polymorphisms in trophoblasts of ectopic tubal pregnancies. Material and methods: A retrospective chart review of tubal ectopic pregnancies was conducted and 34 eligible cases were found. Paraffinized blocks of ectopic trophoblastic tissues were retrieved from the archives of pathology department. Common MTHFR polymorphisms were studied on microdissected trophoblastic tissues. Sixteen cases with history of failed MTX therapy (study group) and 18 control cases were compared for their pertinent clinical characteristics and common MTHFR polymorphisms (C677T&A1298) data. Results: In the study group, there were 8 (50%) C677T single nucleotide polymorphisms (SNP) and 9 (56.7%) A1298C SNP. Polymorphism rates were not found to be different between two groups for neither polymorphism (p > 0.05 for both). Number of compound heterozygotes was 3 (18.7%) in study group and 5 (27.7%) in controls (p = 0.693). In addition, MTHFR polymorphism presence seemed to have no effect on interval serum β-hCG concentration change in MTX-fail group (p=0.693). Conclusions: Our data implied that common MTHFR polymorphisms of ectopic trophoblastic tissue are not associated with MTX failure in patients with tubal pregnancies. Additionally, serum β-hCG concentration changes caused by MTX treatment and studied MTHFR polymorphisms are likely independent.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

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Common Methylenetetrahydrofolate Reductase Polymorphisms (A1298C & C677T) in Ectopic Trophoblasts and Methotrexate Treatment Failure in Tubal Pregnancies

et al. 2018

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“…Even though expectant management of CSEP has been described [2,3,15,18], the safety of continuing pregnancy is questionable. Caution must be exercised when choosing expectant management in cases of viable CSEP as it carries a significant risk of complications, including uterine rupture, severe haemorrhage and hysterectomy [4,18,19].…”

Section: Expectant Managementmentioning

confidence: 99%

“…CSEP is one of the rarest forms of ectopic pregnancies [1][2][3][4][5]. However, in the last two to three decades, an increasing number of case reports and case series have been published [4].…”

Section: Introductionmentioning

confidence: 99%

Caesarean Scar Ectopic Pregnancy

Tadesse¹

2020

Non-Tubal Ectopic Pregnancy

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Caesarean scar ectopic pregnancy (CSEP) is one of the rarest forms of ectopic pregnancy. It is characterised by a gestation implanted in a caesarean section scar and surrounded by the myometrium and the fibrous tissue of the scar. With rising caesarean delivery rates and widespread use of ultrasound in early pregnancy, there is a parallel upward trend in the incidence of CSEP. The most significant risk associated with a CSEP is an early uterine rupture with life-threatening maternal haemorrhage leading to hysterectomy and loss of reproductive potential. An early diagnosis can offer conservative treatment options capable of preserving the uterus. This chapter discusses the clinical presentation, diagnosis and evidence-based treatment options of CSEP.

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