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 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 Management outcomes of ectopic pregnancy depending on different treatment modalities: a cohort study

2021 ◽  
Vol 10 (3) ◽  
pp. 842
Author(s):  
Shawqi H. Alawdi ◽  
Mayada Roumieh ◽  
Marwan Alhalabi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Single Dose ◽  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Expectant Management ◽  
Pelvic Surgery ◽  
Dose Methotrexate ◽  
Significant Difference ◽  
History Of

Background: Ectopic pregnancy is the most common cause of maternal morbidity and mortality during the first trimester of pregnancy. The present study aimed to review and evaluate the management outcomes of ectopic pregnancy in Damascus University Maternity Hospital, Syria.Methods: A retrospective cohort study was performed on women referring to Damascus University Hospital of Obstetrics and Gynecology (OBGYN) for ectopic pregnancy. Patients were assigned into groups by method of treatment: expectant management (Group 1), single-dose methotrexate regimen (Group 2), two-dose methotrexate regimen (Group 3), and surgical intervention (Group 4). Parameters assessed were risk factors for ectopic pregnancies, transvaginal ultrasonography findings, serum human chorionic gonadotropin (hCG) levels on Days 0, 4, 7, and types of surgical intervention in women that underwent any surgical intervention. A treatment modality was considered successful when hCG levels declined to less than 5 mIU/L without further administration of methotrexate dose or need for surgery.Results: Seventy-seven women with ectopic pregnancy were admitted to the hospital during the study period. Groups 1, 2, 3, and 4 constituted 20.8%, 13.0%, 6.5% and 59.7% of the patients respectively. The most common encountered risk factors for ectopic pregnancy in the patients were history of previous intra-abdominal or pelvic surgery (57.1%) and history of miscarriage (41.6%). A statistically significant difference in the serum hCG concentrations measured on day 0, day 4, and day 7 were observed between the groups.Conclusions: The success rate in ectopic pregnancy treatment was 56.25% for the expectant management, 70% for the single-dose methotrexate regimen, and 40% for two-dose methotrexate regimen.

scholarly journals Methotrexate in Unruptured Ectopic Pregnancy: Comparing the Single- and Double-dose Treatment

2018 ◽  
Vol 6 (3) ◽  
pp. 1
Author(s):  
Nazli Navali ◽  
Nasim Jabbari Asl ◽  
Sanaz Moosavi
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Dose Group ◽  
Treatment Success ◽  
The Other ◽  
Double Dose ◽  
Dose Treatment ◽  
Significant Difference ◽  
Β Hcg

Introduction: Ectopic pregnancy (EP) poses a great threat to pregnant women, and in case of misdiagnosis could lead to catastrophic death of the patients. EP patients tend to be treated with surgical or non-surgical treatments. One of the most common therapies in managing EP is Methotrexate (MTX), which the efficacy of its single- and double-dose treatments will be evaluated in this study. Methods: One-hundred and twenty patients with EP, diagnosed in AL-Zahra hospital in Tabriz, Iran, were involved in the study and were divided, randomly, into two groups of 60 (though 4 of the patients in the second group left the study due to discontent, afterwards). For the first group 50 milligrams (mg) of intramuscular (IM) single-dose MTX was prescribed, while for the second group two doses of 50 mg IM MTX were prescribed. The levels of β-hCG were evaluated before the treatment, in the fourth and seventh days, and second and fourth weeks after the treatment. In addition, sonographic findings, clinical symptoms before the treatment, and side effects after treatment were recorded. Results: Success rate for the single-dose group was 85%, while for the double-dose group was 94.6%. However, there was no statistically significant difference between two groups. In addition, there were no significant relations between 2 groups in endometrial thickness, presence of abdominal free fluid and gestational age with the success rate. Regardless, the initial level of β-hCG was an indicator of treatment success rate. In patients with double-dose MTX, required period of time for β-hCG levels to reduce down to zero was significantly lower than the other group. Cut-off point for success rate with single-dose MTX was 3350, with the sensitivity of 88.9% and specificity of 76.5% and for the other group it was 3894.5, with the sensitivity of 66.7% and specificity of 71.7%. Conclusion: No significant difference was observed between single- and double-dose MTX groups in treating EP. The initial levels of β-hCG and mass size were the only factors to predict the treatment success rate. Double-dose regimen lowered β-hCG down to zero earlier than single-dose. Based on Cut-off points, while the initial β-hCG level was below 3350, single-dose treatment was efficient, whereas, between 3350 and 3894.5, double-dose treatment

Cost-Effectiveness of Single-Dose Methotrexate Compared With Laparoscopic Treatment of Ectopic Pregnancy

2000 ◽  
Vol 95 (3) ◽  
pp. 407-412 ◽  
Author(s):  
ROBERT J. MORLOCK ◽  
JENNIFER ELSTON LAFATA ◽  
DAVID EISENSTEIN
Keyword(s):  
Single Dose ◽  
Cost Effectiveness ◽  
Ectopic Pregnancy ◽  
Laparoscopic Treatment ◽  
Dose Methotrexate

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

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