Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

Sendy, Feras; AlShehri, Eman; AlAjmi, Amani; Bamanie, Elham; Appani, Surekha; Shams, Taghreed

doi:10.1155/2015/902426

Cited by 26 publications

(37 citation statements)

References 33 publications

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“…Feras et al [18] found the cure rate of ectopic pregnancy by management with methotrexate was 72%. It shows to be comparatively lower than international rates, an average of 90% [18]. In this study we anticipated to prove that using double doses of methotrexate as a medical management of selected cases of ectopic pregnancies has promising success rate than single dose.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies published different rates of success for medical management of EP either by single or multidose regimens; ranging from 85% to 95% to 100 % by Nguyen et al and Skubisz et al [17]. Feras et al [18] found the cure rate of ectopic pregnancy by management with methotrexate was 72%. It shows to be comparatively lower than international rates, an average of 90% [18].…”

Section: Discussionmentioning

confidence: 99%

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Double Versus Single Dose Methotrexate Regimens in Management of Undisturbed Ectopic Pregnancy

Saleh¹

2016

OGIJ

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Objective: To assess the effectiveness and safety of double-dose methotrexate in comparing to single-dose methotrexate for management of ectopic pregnancy. Methods:A prospective randomized-controlled trial was conducted on 200 patients with ectopic pregnancy at the Obstetrics and gynecological Departments of Zagazig University, Egypt between June, 20 11 to May 2014. Patients were randomized into two groups, (group 1) who received a single dose 50 mg per meters squared surface area methotrexate (50 mg/m 2 IM on day 1) intramuscularly or (group 2), who received double-dose methotrexate regimen (50 mg/m 2 intramuscularly on days 1 and 4). The outcomes were; success rate, time duration of fall down of b-hcg to < 15 mlU/mL and undesirable effects of methotrexate. Results:In general, there is significant differences between both groups as regard the success rate and the duration of fall down β-hCG. The success rate was better in group 2 than in group 1 (90% versus 78.75%, P=0.01). The duration of fall down β-hCG until < 15 mlU/mL was shorter in group 2 (P=0.01). There was no significant difference between groups in adverse effects.Conclusion: Double-dose methotrexate as one of regimens of medical management of undisturbed ectopic pregnancy had more effectiveness and success rate than that of single-dose regimen with equivalent safety.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Double Versus Single Dose Methotrexate Regimens in Management of Undisturbed Ectopic Pregnancy

Saleh¹

2016

OGIJ

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“…However, systemic MTX is safe in hemodynamically stable patients without excessive fluid or clotting, and fluid presence does not affect treatment success, as demonstrated in this study and others 12,24,25. The limitation regarding this study is that we could not determine amounts of pelvic fluid.…”

Section: Discussionmentioning

confidence: 65%

Single-dose methotrexate for the treatment of ectopic pregnancy: Our experience from 2010 to 2015

2017

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Objective:To evaluate the success of systemic single-dose methotrexate (MTX) treatment in patients with ectopic pregnancy (EP) and to investigate factors related to treatment success.Methods:This retrospective study had been performed in Yildirim Beyazit University between January 2010 and December 2015. Demographic and clinical characteristics, ultrasonografic findings, pretreatment serum β–human chorionic gonadotropin (β-hCG) and progesterone levels of 58 patients with EP were retrieved from hospital records retrospectively. The patients were grouped according to MTX treatment success (response vs. failure).Results:Single-dose MTX-treatment was successful in 72.4% (42/58) of patients. The mean pretreatment β-hCG level was significantly lower in responders than in failures (2080 ± 2322 vs. 5707 ± 3885 IU/L, p = 0.001), and 2678 IU/L was the most suitable cutoff to predict success (75% sensitivity, 73.8% specificity). Moreover, failure rate was 8.45 times more in group of patients whose β-hCG values were determined above the cutoff. The presence of fetal cardiac activity adversely affected treatment success (odds ratio = 12, p = 0.004). Treatment success was not affected by past history of ectopic pregnancy, thickness of endometrium, progesterone value or presences of pseudosac and free pelvic fluid.Conclusion:The success rate of single dose MTX in this study was 72.8 %, and we found that failure rate of MTX treatment was 8.45 times more in group of patients whose initial serum β-hCG values were above 2678 IU/L and 12 times more in patients with fetal cardiac activity

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“…Many investigators reported a higher success in a sac diameter up to 3,5 cm, where the others indicated larger than 3,5 cm [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı

Doğru

İşgüder²,

Özsoy³

et al. 2016

J Contemp Med

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Ektopik gebelik tüm gebeliklerin %2'sini oluşturmakta, aynı zamanda vakaların %95'ten fazlası fallop tüplerinde lokalizedir. Bu çalışmada; tubal gebeliklerde metotreksat tedavi başarısını değerlendirmek, ve nötrofil-lenfosit oranı, trombosit-lenfosit oranı ve tubal ektopik gebelik rüptürü arasındaki ilişkiyi incelemek amaçlanmıştır. Gereç veYöntem: Bu retrospektif çalışma, Gaziosmanpasa Üniversitesi, Kadın Hastalıkları ve Doğum Anabilim Dalı'nda 2012 ve 2014 yılları arasında yapılmıştır. Veriler Statistical Package for Social Sciences (SPSS) yazılım versiyonu 20.0 (SPSS Inc., Chicago, IL) ile analiz edildi. Tüm karşılaştırmalarda çift taraflı p değeri < 0.05 olarak kabul edildi.Bulgular: Nötrofil-lenfosit oranı rüptüre olup cerrahi tedavi geçirmiş hastalarda rüptüre olmayıp metotreksat tedavisi alan hastalara göre yüksek saptandı (p = 0.009). Beraberinde, nötrofil-lenfosit oranı metotreksat tedavisine yanıt veren hastalarda yanıt vermeyenlere göre yüksek bulundu (p = 0.027).Sonuç: Ektopik gebelik kese çapı ve B-HCG değeri yanında, nötrofillenfosit oranı ve platelet-lenfosit oranı metotreksat tedavisinin başarısını öngörmede yararlı belirteçler olabilirler.

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Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

Cited by 26 publications

References 33 publications

Double Versus Single Dose Methotrexate Regimens in Management of Undisturbed Ectopic Pregnancy

Double Versus Single Dose Methotrexate Regimens in Management of Undisturbed Ectopic Pregnancy

Single-dose methotrexate for the treatment of ectopic pregnancy: Our experience from 2010 to 2015

Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı

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