Treatment of ectopic pregnancy with methotrexate

Dardalas, Ioannis; Rigopoulos, Panagiotis; Pourzitaki, Chryssa

doi:10.1007/s00404-019-05248-z

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…The current methods for the treatment of cervical pregnancy include systemic medication or local chemotherapeutic debridement. Direct curettage treatment has a high chance of triggering intraoperative hemorrhage and is extremely risky intraoperatively; thus, treating it medically prior to clearance is the key to treatment [ 6 ]. Methotrexate (MTX) chemotherapy has methods of administration such as systemic or ultrasound-guided intrauterine arterial injection, which inhibits trophoblast growth and causes necrosis, shedding, and resorption of embryonic tissue.…”

Section: Introductionmentioning

confidence: 99%

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Gong¹,

Qian

Zhang³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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This is a retrospective study to analyze the efficacy of uterine artery chemoembolization (UACE) combined with ultrasound-guided curettage in the treatment of cervical pregnancy and the factors affecting the postoperative outcome. A total of 26 subjects were included in the study and were divided into a control group of 12 and an observer group of 14, all patients with cervical pregnancy diagnosed in our hospital from January 2016 to January 2020. Patients in the control group were treated with methotrexate injection (MTX) combined with ultrasound-guided curettage in our hospital, while the observer group was treated with UACE combined with ultrasound-guided curettage. The efficacy of the two groups was evaluated at 3 months postoperatively, and data on patients’ age, days of menopause, pregnancy frequency, and vaginal bleeding were collected retrospectively. Intraoperative bleeding, time to recovery of serum human chorionic gonadotropin (HCG), hospitalization time, time to return to normal menstruation, time to disappearance of gestational sac, pregnancy frequency, presence of endometrial inflammation, gestational week, maximum diameter of gestational sac, thinnest myometrium, endogenous-exogenous type, gestational sac size, and HCG level were recorded in both groups. Single-factor analysis and multifactor logistic regression models were used to analyze the factors influencing the surgical outcomes of patients. The results of the study showed that the overall efficiency of the observer group was significantly higher than that of the control group, while intraoperative bleeding, hospital stay, time to return to normal menstruation, and time to disappearance of the gestational sac were all lower than those of the control group ( p < 0.05 ). The results of univariate and multifactorial analyses showed that endometrial inflammation, gestational week, maximum diameter of the gestational sac, thinnest myometrium, and endogenous-exogenous type could affect the patients’ postoperative recovery ( p < 0.05 ); gestational week, maximum diameter of the gestational sac, and thinnest myometrium were independent factors affecting the patients’ postoperative recovery ( p < 0.05 ). The above results suggest that UACE combined with ultrasound-guided uterine clearance for cervical pregnancy can significantly improve treatment efficacy, reduce intraoperative bleeding, and improve recovery time from postoperative related symptoms. The treatment efficacy of patients with cervical pregnancy was related to the gestational week, the maximum diameter of the gestational sac, and the thinnest muscle layer.

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Section: Introductionmentioning

confidence: 99%

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Gong¹,

Qian

Zhang³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Existen informes de casos de embarazos ectópicos abdominales tempranos tratados exitosamente con metotrexato sistémico sin cirugía adicional (5) . Sin embargo, el tratamiento quirúrgico está indicado cuando existe embarazo ectópico roto, concentraciones séricas de gonadotropina coriónica iguales o superiores a 5,000 UI/L, actividad cardiaca fetal o sospecha de embarazo heterotópico (5,16) .…”

Section: Discussionunclassified

Embarazo ectópico retroperitoneal primario

Torres-Cepeda¹,

Rondón-Tapía²

2023

Rev peru ginecol obstet.

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El embarazo ectópico representa 1,5% a 2% de todos los embarazos y es causa común de mortalidad relacionada con el embarazo durante el primer trimestre. La ubicación más común es la trompa de Falopio y menos del 2% son embarazos abdominales. El embarazo ectópico retroperitoneal es un tipo de extremadamente raro con una patogénesis bastante compleja. Esta ubicación inusual tiene un alto riesgo de complicaciones potencialmente mortales. El diagnóstico temprano es difícil por la incapacidad de diferenciar signos, síntomas, concentraciones de gonadotropina coriónica e imágenes con embarazos ectópicos de las ubicaciones inusuales, como el retroperitoneo. Además, es necesario tener cuidado con el diagnostico de estos casos cuando los sitios más comunes de aparición no presentan alteraciones. El tratamiento es la extracción de tejido trofoblástico por laparotomía o laparoscopia. Se presenta un caso de embarazo ectópico retroperitoneal primario.

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“…Якщо рівень b-субодиниці ХГЛ у сироватці зменшився менше, ніж на 15% на восьму добу, метротрексат вводять повторно у тій же дозі. Якщо рівень b-субодиниці ХГЛ у сироватці збільшився понад 15%, хвору спостерігають, щотижня визначають рівень b-субодиниці ХГЛ до тих пір, поки цей рівень не буде менше 10 МЕ/л [1,4,6,10].…”

Section: результати обговоренняunclassified

Ectopic pregnancy of cervical localization: modern aspects of treatment

Lovkina¹,

Kosianenko²,

Klivak³

et al. 2022

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. A review of the scientific literature on the problem of diagnosis and modern methods of treatment of cervical pregnancy is presented. Ectopic pregnancy (ectopic pregnancy) is a condition in which the implantation and development of a fertilized egg takes place outside the uterine cavity and is one of the threatening conditions for life and reproductive health of women. Cases of cervical pregnancy occur with a frequency between 1:8 600 and 1:12 400 cases of the total number of all pregnancies and less than 1% of the number of ectopic pregnancies. Suspicion of a diagnosis of “cervical pregnancy” is an indication for immediate hospitalization of the woman in a gynecological hospital, a thorough examination and selection of treatment, because this pathology can provoke massive bleeding in the first trimester of pregnancy. In the practice of obstetrician-gynecologist for a long time there was one method of treatment of this pathology – extirpation of the uterus. To date, there are conservative and surgical treatments, that we will cover in this article. We conducted a systematic review and analysis of relevant literature sources, which have been published in the vast majority over the past 10 years (2012-2022), on modern methods of diagnosis and treatment of cervical pregnancy. The search was conducted in search databases PubMed, Google Scholar, Cochrane Library, Web of Science. The following search terms were used in the work: “cervical pregnancy”, “ectopic pregnancy”. It was found that the problem of treatment of cervical pregnancy remains relevant today, because there is no clear opinion on the best method of treatment. The decision to use one or another method is left to the attending physician, who must adequately assess the patient's condition, obstetric situation and possible options for prescribing appropriate treatment, the available methods were justified.

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Treatment of ectopic pregnancy with methotrexate

Cited by 3 publications

References 4 publications

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Embarazo ectópico retroperitoneal primario

Ectopic pregnancy of cervical localization: modern aspects of treatment

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