Initial Rise of Serum hCG Levels After Methotrexate Therapy Is Associated with a Lower Success Rate of Medical Treatment in Patient Diagnosed with Ectopic Pregnancy

2016 ◽  
Vol 23 (7) ◽  
pp. S87
Author(s):  
R Mashiach ◽  
I Kislev ◽  
D Gilboa ◽  
DS Seidman ◽  
S Afek ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Methotrexate Therapy ◽  
Initial Rise ◽  
Lower Success Rate

Evaluation of tubal patency using hysterosalpingo-contrast sonography (HyCoSy) following salpingostomy and medical treatment of tubal pregnancy

2021 ◽  
Vol 20 (4) ◽  
pp. 12-16
Author(s):  
Aml El-Shabrawy ◽  
◽  
Ahmed Elsheikh ◽  
Samy Gebreel ◽  
Mohammed Elsokkary ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Fallopian Tube ◽  
Tubal Pregnancy ◽  
Tubal Patency ◽  
Group I ◽  
Case Series Study ◽  
Maternity Hospitals ◽  
Significant Difference

Objective. Ectopic pregnancy adversely affects the patency of the fallopian tube and consequently the future pregnancy. There are different options of conservative treatment of tubal pregnancy such as methotrexate and salpingostomy [1]. There is little information on the success rate of maintaining tubal patency after methotrexate and salpingostomy [2]. Therefore, the aim of this study is to evaluate the ipsilateral tubal patency using HyCoSy after treatment of tubal pregnancy with methotrexate therapy versus salpingostomy. Patients and methods. This was a case-series study conducted in Ain Shams and Al-Azhar University Maternity Hospitals to evaluate the ipsilateral tubal patency using hysterosalpingo-contrast sonography (HyC0Sy) following salpingostomy and medical treatment of tubal pregnancy. This study included patients who were admitted to Ain Shams and Al-Azhar University Maternity Hospitals for having tubal pregnancy and were treated either with methotrexate or salpingostomy over a 4-year period between January 2017 and December 2020. The patients seeking fertility were re-evaluated for fallopian tubes patency by hysterosalpingogram 3 months after discharge. The study included 2 groups of women: group I (n = 200): women who were treated with methotrexate, and group II (n = 140): women who underwent salpingostomy. Results. HSG was performed in 200 cases of patients with tubal pregnancy who were treated with methotrexate and 140 cases of patients who underwent salpingostomy. The patency of the ipsilateral tube was 85% after methotrexate treatment and 84.2% after salpingostomy. There was no statistically significant difference between the two groups. Conclusion. The findings suggest similar success rate in maintaining the patency of the fallopian tube with either methotrexate or salpingostomy. Key words: ectopic pregnancy, hysterosalpingography, methotrexate, infertility, salpingostomy

scholarly journals Hysterosalpingography for tubal patency after methotrexate therapy for ectopic pregnancy

2020 ◽  
Vol 6 (3) ◽  
pp. 76-79
Author(s):  
Ahmed A Aboelroose ◽  
Ahmed M Fakhr Eldein ◽  
Waleed A Sayed Ahmed ◽  
Omima T Taha
Keyword(s):  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Significant Risk ◽  
Methotrexate Therapy ◽  
Reproductive Age ◽  
P Value ◽  
University Hospitals ◽  
Tubal Ectopic Pregnancy ◽  
Tubal Patency ◽  
History Of

ntroduction: Ectopic pregnancy is a serious cause of tubal loss or dysfunction among women in the reproductive age. Medical treatment is a commonly prescribed management under certain circumstances. It is associated with a high success rate, but tubal affection is a result. This study evaluated the effect of medical treatment on patients with unruptured tubal pregnancy. Materials and methods: This was a prospective cohort study conducted at the Obstetrics and Gynecology Department of Suez Canal University Hospitals, from January 2016 to June 2019. We recruited Fifty- six patients with unruptured tubal pregnancy.All patients were managed with medical treatment, methotrexate therapy. After confirmation of successful medical treatment, hysterosalpingography was done three months after treatment for the evaluation of tubal patency.The outcome measure was the rate of tubal patency after medical treatment for unruptured tubal ectopic pregnancy. Results: The present study revealed that 71.4% of patients (40 cases) had patent tubes, and 28.6% had blocked tubes. Moreover, 21.4% of patients have ipsilateral tubal block only, 3.6% have a contralateral tubal block, and 3.6% have a bilateral tubal block. Significant risk factors for tubal block were history suggestive of PID, acute PID hospitalization, and history of septic miscarriage (p value < 0.05). Conclusion: Methotrexate provided successful fertility-preserving treatment for women with unruptured ectopic pregnancy, yet associated with tubal block

Retrospective Analysis of Follow-up and Treatment of Patients With Ectopic Pregnancy and Our 6 Years of Clinical Experience

2020 ◽  
Vol 1 (3) ◽  
pp. 85-91
Author(s):  
Xayala Muradova ◽  
Ece Bahçeci ◽  
Keziban Dogan
Keyword(s):  
Laparoscopic Surgery ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Retrospective Analysis ◽  
Treatment Success ◽  
Molar Pregnancy ◽  
Rupture Rate ◽  
Tertiary Center

Objective: In this study, we aimed to make a retrospective analysis of the follow-up and the treatment of the patients who were admitted to our clinic, which is a tertiary center, with the preliminary diagnosis of ectopic pregnancy between 2010-2016 in order to contribute to the data related to ectopic pregnancy in our country.Materials and Methods: We retrospectively evaluated the follow-up and the treatment of 452 patients who were admitted to our clinic with a diagnosis of ectopic pregnancy between 2010-2016. We separated these cases into different groups according to their diagnosis, the way of treatment and results.Results: The study was conducted in …….. Hospital, between 2010-2016 with 452 female cases. We did not visualize any ectopic mass in 12,6% of the cases (n = 57); 85% (n = 385) was tubal; 0.2% (n = 1) was cornual; 1.2% (n = 5) was ovarian, 0.2% (n = 1) was heterotropic; 0.4% (n = 2) was molar pregnancy, and 0.2% (n = 1) was scar pregnancy. Methotrexate(MTX) treatment success rate was 72.7% 17% (n = 77) of the cases used MTX; general rupture rate of the cases were 25,7% (n = 116); rupture rate after MTX treatment was 27.2% (n = 21). In the MTX group the rate of detecting an ectopic mass was significantly higher (p = 0.001; p <0.01). 74.1% (149 cases) of the cases we performed laparoscopy and 25.8% (53 patients) of the cases we performed laparatomy. 86% (173 patients) was performed salpingectomy, 10.9% (18 patients) salpingostomy, and 2.9% ovarian resection.Conclusion: Looking at the data in our clinic, we use follow-up, surgical and medical treatment methods. The success rate of medical treatment was 72.7% and laparoscopic surgery was performed in 74.1% of the cases.

scholarly journals Safety and Efficacy of Methotrexate In Unruptured Ectopic Pregnancy

2016 ◽  
Vol 28 (1) ◽  
pp. 5-8
Author(s):  
Quorrata Eynul Forhad ◽  
Masuda Begum ◽  
Irin Parveen Alam ◽  
Md Shah Alam
Keyword(s):  
Side Effects ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Medical Management ◽  
Multiple Dose ◽  
Cost Effective ◽  
Successful Outcome ◽  
Imaging Data ◽  
High Definition

Introduction: Medical management of an unruptured ectopic pregnancy with intramuscular methotrexate is a common and cost-effective alternative to surgery1. This therapeutic transition from surgical emergency to medical management has been attributed to early diagnosis through the use of sensitive assays for ?-hCG and the high definition vaginal ultrasound.Objectives: The aim of the study was to observe the efficacy and safety of medical treatment either by a single or multiple dose of methotrexate to cure ectopic pregnancy.Materials and methods: A retrospective study from January 2005 – June 2008 was carried out, collecting clinical imaging data and serum ?-hCG, time taken for complete ?-hCG resolution was recorded and negative ?-hCG result was used as an endpoint of successful outcome. Out of 14 cases, where Methotrexate (50 mg I/M) was used, two required surgery for symptom of rupture. In the remaining 12 cases, there was no side effects, complete ?-hCG resolution was achieved in 10 of the12 medically treated cases (85% success rate) within 28 days. Rest of the 2 cases needed multiple doses of Methotrexate.Results: Over all success rate was 85%. In 71% cases recovery was uneventful and complete within 7 days of treatment (Table 1). Two patients needed surgical treatment and in another one case there was abdominal pain which subsided after analgesic. Ten patients were cured by single dose only and 2 patients needed multiple dose. There was no side effects or complication of drug in any case.Conclusion: Methotrexate is safe and effective for unruptured ectopic pregnancies that satisfy the strict criteria with no side effects and the advantage of avoiding invasive surgery. This small trial gave a good impression about medical treatment in selective cases.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 5-8

Methotrexate Therapy in Obstetricaĺ Diseases

2016 ◽  
Vol 4 (1) ◽  
pp. 9 ◽  
Author(s):  
Aneta Tomescu ◽  
Rodica Sîrbu ◽  
Stelian Paris ◽  
Emin Cadar ◽  
Cristina Luiza Erimia ◽  
...  
Keyword(s):  
Clinical Pharmacology ◽  
Side Effects ◽  
Ectopic Pregnancy ◽  
Malignant Disease ◽  
Surgical Intervention ◽  
Hydatidiform Mole ◽  
Medical Abortion ◽  
Methotrexate Therapy ◽  
Therapeutic Effects ◽  
Neoplastic Diseases

Our study is a rewiew of Methotrexate therapy in obstetrica? diseases such us: hydatidiform mole, and medical abortion. In the medical world, methotrexate is a citostatic drug used in neoplastic diseases. The clinical pharmacology data regarding methotrexate is presented, alongside route of administration and therapeutic effects in malignant disease, hydatiform mole, and medical abortion. The use of methotrexate in medical abortion and ectopic pregnancy is a great accomplishment, as it replaces a surgical intervention marred by characteristic side effects, with similar results.

Methotrexate Therapy in Obstetricaĺ Diseases

2016 ◽  
Vol 2 (1) ◽  
pp. 9 ◽  
Author(s):  
Aneta Tomescu ◽  
Rodica Sîrbu ◽  
Stelian Paris ◽  
Emin Cadar ◽  
Cristina Luiza Erimia ◽  
...  
Keyword(s):  
Clinical Pharmacology ◽  
Side Effects ◽  
Ectopic Pregnancy ◽  
Malignant Disease ◽  
Surgical Intervention ◽  
Hydatidiform Mole ◽  
Medical Abortion ◽  
Methotrexate Therapy ◽  
Therapeutic Effects ◽  
Neoplastic Diseases

Our study is a rewiew of Methotrexate therapy in obstetrica? diseases such us: hydatidiform mole, and medical abortion. In the medical world, methotrexate is a citostatic drug used in neoplastic diseases. The clinical pharmacology data regarding methotrexate is presented, alongside route of administration and therapeutic effects in malignant disease, hydatiform mole, and medical abortion. The use of methotrexate in medical abortion and ectopic pregnancy is a great accomplishment, as it replaces a surgical intervention marred by characteristic side effects, with similar results.

Cervical Automated Discectomy

1996 ◽  
Vol 2 (1) ◽  
pp. 35-44 ◽  
Author(s):  
J. Theron ◽  
H. Huet ◽  
O. Coskun
Keyword(s):  
Medical Treatment ◽  
Success Rate ◽  
Open Surgery ◽  
Ligamentum Flavum ◽  
Outpatient Basis ◽  
Complementary Technique ◽  
First Choice ◽  
Lumbar Area ◽  
Safe Technique ◽  
Cervical Disk

The lumbar automated discectomy system described by Onik has been used in the treatment of cervical disk herniations whose symptomatology resisted medical treatment. Experience on 150 patients is reported showing a 74.5% success rate. This series performed in most cases on an outpatient basis had no complications. Up to 1992 failure cases were treated by intradiscal injections of triamcinolone with 62% of success. This complementary technique was abandonned after the description of epidural calcifications secondary to this type of injections in the lumbar area. Since 1992, failure cases have been managed differently with injections of steroids in the cervical joints, especially when a hypertrophy of the ligamentum flavum supposedly a sign of an inflammatory posterior component of the pain was demonstrated on the CT. Nine patients received intradiscal injections of microdoses (600 IU) of chymopapaine with excellent results. No patient has had open surgery since 1992. It is concluded that percutaneous automated discectomy is a very promising and safe technique which can be used as a first choice technique for most cervical disk herniations resisting medical treatment.

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