Comparative study of low‐dose versus standard single‐dose methotrexate: A novel approach for medical treatment of ectopic pregnancy

2020 ◽  
Author(s):  
Gültekin A. Aydın ◽  
Gülten Özgen ◽  
Arzu Yavuz
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Low Dose ◽  
Dose Methotrexate ◽  
Novel Approach

The effect of ultrasonography in predicting medical treatment success in ectopic pregnancy

2019 ◽  
Vol 1 (1) ◽  
pp. 5-7
Author(s):  
Meric Balikoglu ◽  
Burak Bayraktar ◽  
Mert Mevlüt Akar
Keyword(s):  
Single Dose ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Treatment Success ◽  
Dose Methotrexate ◽  
Treatment Prediction ◽  
Significant Difference ◽  
Mass Size ◽  
The Right

Ectopic pregnancy(EP) treatment success in a single dose methotrexate(MTX) regimen is decided by more than 15% β chorionic gonadotropin reduction in the 4th and 7th days after administration of 50mg/m² of medication.  In our study , it was aimed whether the EP mass size less than 40mm detected by ultrasonography and the adnexal side on which it was located had an effect on the success of medical treatment. 82 patients who treated with MTX included in the study were divided into two groups as those with a single dose of methotrexate success and those without (n:67 vs n:15). The groups were compared in terms of age, parity, size of adnexal mass detected on ultrasonography, and the side of ectopic pregnancy. The parity rates and the age of patients were similar in both groups(p = 0.615, p = 0.742). Although the average adnexal mass size was found to be higher in the patient group those single dose MTX treatment was not successful, there was no statistically significant difference(p = 0.098). Ectopic pregnancy was frequently observed on the right side in the group in which the medical treatment was successful(66 % vs 33%). The effect of ectopic pregnancy mass size on medical treatment prediction was investigated in cases with mass size less than 40mm. Ectopic pregnancy mass size, even if it is below 40 mm, may not indicate the medical treatment success.

scholarly journals Medical Management of Ectopic Pregnancy: An Observational Study

2016 ◽  
Vol 29 (1) ◽  
pp. 32-36
Author(s):  
Shahana Begum ◽  
Rowshan Akhtar
Keyword(s):  
Single Dose ◽  
Observational Study ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Medical Management ◽  
Progesterone Level ◽  
Fertility Treatment ◽  
Intrauterine Pregnancy ◽  
College Hospital ◽  
Serum Progesterone

Objectives: The aim of this study was to explore the safety and efficacy of medical management of ectopic pregnancy.Materials and methods: This prospective observational study was conducted between February 2011 to August 2013 in Chittagong Medical College Hospital (CMCH) and in different private clinics of Chittagong city. Twenty-seven patients of ectopic pregnancy conceived by fertility treatment were recruited for medical treatment after proper evaluation. Ectopic pregnancy was diagnosed by serum ?-hCG and progesterone level but missing intrauterine pregnancy by transabdominal sonography (TAS). Serum ?-hCG was repeated after 48 hours to observe doubling of the level. If level was not doubled or increment was not at least 66% and serum progesterone level was less than 15ng/ml then it was considered as ectopic pregnancy. Patients were treated with Injection methotrexate 50 mg intramuscularly either by single dose or two doses. After 4 days of 1st injection ?-hCG was repeated and if level decreased > 15% then patients were assessed weekly till ?-hCG fell to <5lU/L. If drop was <15% after 4 days a second dose of methotrexate was given.Results: Overall success rate was 66.66% . Surgical intervention was needed in 22.22% patients. All patients were treated after hospitalization in CMCH and different private clinics of Chittagong. They got injection methotrexate, antibiotic, antispasmodic and analgesics for abdominal pain. Single dose cured 55.55% patients and 11.11% patients needed second dose, another 11.11% patients were misdiagnosed –later on they were diagnosed as intrauterine pregnancy and medical termination was done. Within one year of treatment 33.33% patients conceived again. There was no side effect or complications of the treatment.Conclusion: This small trial gave a good impression about medical treatment in selective cases. The efficacy should be assessed in a randomized clinical trial with a different set of populationBangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 32-36

scholarly journals Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Feras Sendy ◽  
Eman AlShehri ◽  
Amani AlAjmi ◽  
Elham Bamanie ◽  
Surekha Appani ◽  
...  
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Failure Rate ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Treatment Modalities ◽  
Pregnancy Failure ◽  
Dose Methotrexate ◽  
Mass Size ◽  
Primary Management

Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure.Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate.Results. 225 patients had methotrexate. Most of the patients (151 (67%)) received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225) of the patients. 28% (63/225) were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63) of failure received a second dose of methotrexate, and 37% (23/63) underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound.Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

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

2017 ◽  
Vol 33 (1) ◽  
Author(s):  
Emre Erdem Taş ◽  
Gülin Feykan Feykan Yeğin Akçay ◽  
Ayse Filiz Avsar
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Dose Methotrexate

scholarly journals The Importance of Gestational Sac Size of Ectopic Pregnancy in Response to Single-Dose Methotrexate

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Parichehr Kimiaei ◽  
Zahra Khani ◽  
Azadeh Marefian ◽  
Maryam Gholampour Ghavamabadi ◽  
Maryam Salimnejad
Keyword(s):  
Single Dose ◽  
Confidence Interval ◽  
Ectopic Pregnancy ◽  
Baseline Level ◽  
Surgical Intervention ◽  
Dose Methotrexate ◽  
Causal Pathway ◽  
Gestational Sac ◽  
Logistic Regressions ◽  
Predictor Factors

This retrospective cohort study was designed in a selective group of 185 patients diagnosed with and treated for ectopic pregnancy. Intramuscular administration of a single dose of methotrexate (50 mg/m2) was performed to measure predictors of failure or resistance to treatment necessitating surgical intervention. During the time of treatment with a single dose of MTX, 20 patients (10.8%) failed to response, in which 6 of 20 (30%) indicated side effects to MTX and rupture of the ectopic pregnancy. Remaining cases () showed resistance to the drug; the level of β-hCG did not fall at least 15% during 7 days after treatment and necessitated laparotomy. In backward-step analysis by multiple logistic regressions of various types of predictor factors, size of gestational sac (coefficient = 1.91, OR = 6.78, 95% confidence interval = 3.18–8.22) and baseline level β-hCG (coefficient = 1.60, OR = 5.0, 95% confidence interval = 4.26–6.72) had significant correlation with leading EP patients failing to response to MTX. This study suggests that further investigation for finding relative contraindications of MTX treatment in EP women should be considered on the gestational sac size because other variables are in the causal pathway of this variable.

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