scholarly journals ECTOPIC PREGNANCY;

2012 ◽  
Vol 19 (02) ◽  
pp. 242-245
Author(s):  
ROBINA ALI ◽  
Uzma AFZAL
Keyword(s):  
Early Diagnosis ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Study Design ◽  
Medical Management ◽  
Surgical Intervention ◽  
Resolution Time ◽  
Safe Alternative ◽  
Extrauterine Pregnancy ◽  
Medical College

Objectives: To assess the effectiveness of systemic methotrexate for treatment of unruptured ectopic pregnancy. Introduction:Ectopic Pregnancy is pregnancy that occurs in any location other than the uterus. 95% to 98% are tubal ectopics, but the number of ovarian,abdominal and cervical implantations is rising as does the number of heterotopic pregnancies. Study Design: Prospective experimental study.Setting: DHQ Hospital affiliated with Punjab Medical College Faisalabad. Period: Jan-2009 to Dec-2009. Patient & Method: A total of 45women were admitted with diagnosis of extrauterine pregnancy. But only 10 women fulfilled the criteria for medical management. Out of these80% patients required no surgical intervention. However 20% needed surgery. 60% patients suffered from lower abdominal or pelvic pain. 20%required 2nd dose of methotrexate. Average ß-hCG resolution time was 35 days. Conclusions: With early diagnosis and proper selectioncriteria adoption, medical treatment of ectopic pregnancy with systemic methotrexate is an effective and safe alternative to surgicalinterventions.

scholarly journals Ectopic pregnancy managed medically at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2021 ◽  
Vol 14 (3) ◽  
pp. 85-88
Author(s):  
Jok Thikuiy Gang ◽  
Sisay Kirba Kea ◽  
Samson Gebremedhin
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Records ◽  
Selection Criteria ◽  
Surgical Intervention ◽  
Addis Ababa ◽  
Safe Alternative ◽  
Medical College ◽  
Endometrial Cavity ◽  
Emergency Surgical Intervention ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.

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 ECTOPIC PREGNANCY

2018 ◽  
Vol 25 (08) ◽  
pp. 1164-1167
Author(s):  
Fareeha Khaliq Khan ◽  
Rubina Iqbal ◽  
Zaibunnisa -
Keyword(s):  
Single Dose ◽  
Medical Treatment ◽  
Study Design ◽  
Medical Management ◽  
Case Series ◽  
First Line ◽  
Management Protocol ◽  
Baseline Levels ◽  
Β Hcg ◽  
Study Setting

Introduction: Medical treatment is the first step in the treatment of ectopicpregnancy (EP) now days. Medical treatment with Methotrexate for EP is safe and effectivemethod without the risks associated with the surgical procedure. Objectives: To determine thesuccess rate of single dose of Methotrexate for medical management of females presentingwith EP. Study Design: Quasi trial study. Setting: Department of Obstetrics & Gynaecology,Fatima Memorial hospital, Lahore. Period: 1 year from September 2014 till August 2015.Material & Methods: Study design was prospective descriptive case series in which a totalof 140 women, age 20-45 years of any parity with confirmed EP, were included. Females wereprescribed Methotrexate 50mg/m2, as a single dose. β-HCG level was measured again at 7thday. If β-HCG was decreased by >15% of baseline levels and decrease in the size of masson USG, then success was labeled. Data was entered and analyzed using computer programSPSS version 20. Results: Mean age of women in this study was 32.38±6.34 years. At 3rd daypost-treatment day, mean level of β-HCG was 2019.51 ± 293.39 and at 7th day, mean β-HCGlevel was 1127.44 ± 403.78. At 7th day, there were 125(89.3%) patients whose β-HCG level wasdecreased by >15% and success was labelled. Conclusion: Based on findings of this study itcan be concluded that Methotrexate can be used as first line management protocol for EP as itwas successful in a high percentage of patients.

scholarly journals Comparison of efficacy safety morbidity and complications of conservative and surgical management of ectopic pregnancies in government TD medical college, Alappuzha, Kerala, India

2017 ◽  
Vol 6 (4) ◽  
pp. 1473
Author(s):  
Laila C. Markose ◽  
Sathiamma P. K.
Keyword(s):  
Abdominal Pain ◽  
Hospital Stay ◽  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Medical Management ◽  
Vaginal Bleeding ◽  
Selection Criteria ◽  
Uterine Cavity ◽  
Management Options ◽  
Medical College

Background: Ectopic pregnancy is pregnancy with implantation of fertilized ovum outside the uterine cavity most commonly in the fallopian tube. Objective of the study was to compare the efficacy, safety, morbidity and complications of conservative and surgical management of ectopic pregnancy.Methods: This is a descriptive study at Government Medical College Alappuzha, Kerala, India to analyze safety morbidity efficacy and complications of conservative medical and surgical management of cases of ectopic pregnancy admitted over a period of one year from May 2011 to April 2012. The study group comprised of 81patients with early pregnancy complaining of abdominal pain, vaginal bleeding, amenorrhoea and no intra uterine gestationsonologically. After confirming diagnosis management options included conservative, surgical or medical management with methotrexate as per selection criteria. Maternal morbidity in terms of hospital stay, blood transfusion, side effects of drugs were compared in both groups.Results: Accurate diagnoses of cases were done. Presenting complaints of the study subjects where vaginal bleeding, abdominal pain and amenorrhoea, which was in variably present in all subjects. Laparotomy done in 71.6% case, methotrexate given for 27.2% cases, laparoscopy for 1.2% all without significant morbidity. Two cases of failed medical management had laparotomy in view of tubal rupture.Blood transfusion given for18.4% case.Conclusions: Hospital stay was more in medically managed group. Sticking on to proper selection criteria both methods are safe and effective without any complications or failure.

scholarly journals Medical management of ectopic pregnancy

2020 ◽  
Vol 9 (9) ◽  
pp. 3809
Author(s):  
Tseten Zangmu Bhutia ◽  
Zigmee Dorjee Tamang ◽  
Goutam Giri
Keyword(s):  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Failure Rate ◽  
Medical Management ◽  
Treatment Options ◽  
First Trimester ◽  
Benign Condition ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
Period Of Gestation

Background: Ectopic pregnancy is a commonest cause of maternal morbidity and mortality in the first trimester of pregnancy. Clinical presentation of ectopic pregnancy has changed from life threatening disease to a more benign condition for which nonsurgical treatment options are available with methotrexate administered systemically or locally. The study was done to evaluate the outcome of medical management of ectopic pregnancy with single regimen methotrexate.Methods: A cohort study was conducted over 18 months on 60 unruptured ectopic pregnancies who were treated with methotrexate injection.Results: Out of 60 unruptured ectopic pregnancies, 53 (88.3%) were successfully treated with methotrexate. Failure rate was 11.7% (7/60) patients who underwent laparotomy. Success of medical treatment was dependent on pretreatment β-hCG (≤4102.5 mIU/mL), period of gestation (≤5 weeks), size of gestational sac (≤3 cm) above which the failure rate increases. No correlation was seen between fall of β-hCG from day 4 to 7 and the success rate. Mean time to resolution of β-hCG seen was 4.3±1.25 weeks. Mean duration of hospital stay was 8.85±1.603 days. Single dose regimen of methotrexate was given to all patients and only 1/60 patients required second dose of methotrexate for suboptimal decrease of β-hCG.Conclusions: The result showed that pretreatment β-hCG level and period of gestation were good predictors for success of medical treatment.

scholarly journals Medical management of unruptured interstitial pregnancy with mifepristone and methotrexate

2016 ◽  
Vol 4 (1) ◽  
pp. 34-36 ◽  
Author(s):  
Usha Karki ◽  
Rachana Saha
Keyword(s):  
Single Dose ◽  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Medical Management ◽  
Uterine Cavity ◽  
Interstitial Pregnancy ◽  
Muscular Layer ◽  
Medical College ◽  
Future Pregnancy ◽  
Interstitial Ectopic Pregnancy

Ectopic pregnancy is a serious complication of pregnancy in which embryo gets implanted any where other than the uterine cavity. In interstitial pregnancy, the pregnancy is located in that part of the fallopian tube that penetrates the muscular layer of the uterus. Overall incidence of ectopic pregnancy is one to two percent among which the incidence of interstitial pregnancy is only two percent. Interstitial pregnancy being the hazardous type requires immediate management. Though surgical treatment is the management of choice, its association with decreased fertility rate and increased rate of uterine rupture in future pregnancy cannot be ignored. We hereby report of medical management of interstitial ectopic pregnancy with single oral dose of Mifepristone 200mg along with single dose of Methotrexate 50miligram intramuscularly.Journal of Kathmandu Medical College, Vol. 4(1) 2015, 34-36

scholarly journals H D. Ingraham. A brief report of three cases of ectopic pregnancy (New-York Medical Journal, 1892, December 31). A brief report on 3 cases of extrauterine pregnancy

2020 ◽  
Vol 7 (5) ◽  
pp. 420
Author(s):  
V. Kaplyanskiy
Keyword(s):  
New York ◽  
Medical Journal ◽  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Broad Ligament ◽  
Extrauterine Pregnancy ◽  
The Third ◽  
First Case ◽  
History Of

In the first case, the patient deliberately concealed the history of her illness, deliberately gave inconsistent data and thereby made it extremely difficult to diagnose. When the rupture of the fetal beetle in the abdominal cavity was clear, the patient resisted any surgical intervention and died. In the second case, the rupture of the fetal baby also occurred in the abdominal cavity, blood poured out, accumulated in the Douglas space, and the evacuation of the blood cyst per vaginam ended in the patient's recovery. In the third, an accidental fetus ruptured in the broad ligament and the egg now died.

scholarly journals Role of methotrexate in ectopic pregnancy

2020 ◽  
Vol 10 (1) ◽  
pp. 84
Author(s):  
Munjal J. Pandya ◽  
Neha V. Ninama ◽  
Chirag V. Thummar ◽  
Meet K. Patel
Keyword(s):  
Ectopic Pregnancy ◽  
Success Rate ◽  
Surgical Intervention ◽  
Cost Effective ◽  
First Trimester ◽  
Medical College ◽  
Beta Human Chorionic Gonadotropin ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention.

scholarly journals Medical management of ectopic pregnancy - a case history

2015 ◽  
Vol 6 (1) ◽  
pp. 38-39
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Adnexal Mass ◽  
Pregnancy Complication ◽  
Medical College ◽  
Alternative Treatment Option ◽  
The World ◽  
Life Threatening ◽  
Reducing Costs ◽  
First Time

Ectopic pregnancy described for the first time in the11th Century and later on it was described as pregnancy complication. Ectopic pregnancy is potentially life-threatening and remains the leading cause of maternal death. The incidence of ectopic pregnancy is increased during last years all over the world. Though Laparoscopic surgery is still the cornerstone of treatment in the majority of women, medical management is an alternative treatment option. If the diagnosis of ectopic pregnancy can be made earlier non-invasively, medical treatment with systemic intramuscular Methotrexate (MTX) aimed at reducing mortality, morbidity and reducing costs, minimal intervention/non intervention on comparing with outcomes of surgical treatment. Fertility can be preserved also. Here we presented a case of recurrent ectopic pregnancy with left adnexal mass and stable general condition was treated with MTX successfullyNorthern International Medical College Journal Vol.6(1) 2014: 38-39

Article Commentary: Symptomatic Splenomegaly in Polycythemia Vera: A Review of the Indications for Splenectomy and Perioperative Considerations

2009 ◽  
Vol 75 (5) ◽  
pp. 363-368
Author(s):  
Melissa S. Logan ◽  
Christopher M. Watson ◽  
James M. Nottingham
Keyword(s):  
Medical Treatment ◽  
Polycythemia Vera ◽  
19Th Century ◽  
Medical Management ◽  
Surgical Intervention ◽  
Special Consideration ◽  
Indications For Surgery ◽  
Late 19Th Century ◽  
Treatment Indications ◽  
The Subject

Polycythemia vera is a condition that surgeons do not commonly encounter. Advances in medical management have largely led to avoidance of surgical intervention in most patients. Indications and timing of splenectomy have been the subject of debate since the disease was first described in the late 19th century. Though anemia and thrombocytopenia associated with polycythemia vera only transiently respond to splenectomy, painful splenomegaly with infarction or compression of surrounding viscera are presently accepted indications for surgery. Special consideration must be given to polycythemia vera patients both preoperatively and postoperatively due to altered coagulation and anatomy. We present a review of the pathophysiology, medical treatment, indications for surgical intervention, and perioperative considerations for polycythemia vera.

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