scholarly journals Outcome of Methotrexate Management in Tubal Ectopic Pregnancy: A Retrospective Study in Women's Hospital in Qatar

2015 ◽  
Vol 9 (2) ◽  
pp. 118-122
Author(s):  
M Gasim ◽  
Mohamed Diai ◽  
Mohammed Taha ◽  
Mona Alsaadi ◽  
Prem Chandra ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Obstet Gynecol ◽  
Tubal Ectopic Pregnancy ◽  
Institutional Review ◽  
Beta Human Chorionic Gonadotropin ◽  
Β Hcg ◽  
Study Inclusion

ABSTRACT Objective Ectopic pregnancy case fatalities have decreased dramatically, although incidence has remained steady over years. Advancement in early diagnosis methods and introduction of methotrexate (MTX) in the management has led to such improvement. Different protocols, such as single, two dose and multiple doses of MTX has been indorsed by the American congress of obstetrics and gynecology. Here at Women's Hospital in Qatar we use single dose protocol. However, there no previous report on the outcome of MTX in term success rate in Qatar. Methods A retrospective study on patients diagnosed with tubal ectopic pregnancy between Jan 2008 and Dec 2010 were conducted. Institutional review board of Hamad Medical Corporation, Qatar, approved this study. Statistical analysis were done using SPSS Inc. Ver 20, Chicago, IL. Results Two hundred and forty-eight file met the study inclusion and exclusion criteria, but only 196 completed their followup until beta-human chorionic gonadotropin (â-hCG) less than 15 IU/L. Methotrexate prescribing has increased three times over the study period. The success rate for MTX was 89% and it was positively correlated with lower initial β-hCG levels. However, six out six patients with in β-hCG levels more than 10,000 IU/L were successfully treated with MTX. Conclusion Methotrexate is effective method of treatment in stable patients. Further studies are required to investigate role of MTX in patients with high β-hCG levels (> 10,000 IU/L). How to cite this article Gasim M, Diai M, Taha M, Alsaadi M, Chandra P, Mohamed A, Bayo AI, Ahmed B. Outcome of Methotrexate Management in Tubal Ectopic Pregnancy: A Retrospective Study in Women's Hospital in Qatar. Donald School J Ultrasound Obstet Gynecol 2015;9(2):118-122.

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.

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

Mature solid tubal teratoma producing β-HCG simulating a ruptured tubal ectopic pregnancy

2016 ◽  
Vol 198 ◽  
pp. 165-166
Author(s):  
Diana Dopico Vázquez ◽  
Ana Pereda Ríos ◽  
Cristina Freire Calvo ◽  
Pedro Rodríguez Barro ◽  
Cristina Guillán Maquieira ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Β Hcg

scholarly journals Unexpected rupture of an expectantly managed tubal ectopic pregnancy: a reminder for enhanced diligence

2019 ◽  
Vol 12 (12) ◽  
pp. e230876
Author(s):  
Amenda Ann Davis ◽  
Kusum Lata ◽  
Akshita Panwar ◽  
Alka Kriplani
Keyword(s):  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Expectant Management ◽  
Close Monitoring ◽  
Original Diagnosis ◽  
Tubal Ectopic Pregnancy ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
Asymptomatic Women ◽  
Low Serum

Expectant management of tubal ectopic pregnancies is a feasible and possibly preferable method of management in asymptomatic women with low serum β-human chorionic gonadotropin (hCG). This involves serial monitoring of β-hCG until negative, after which it is deemed as spontaneously resolved ectopic pregnancy. We describe a case of tubal ectopic pregnancy which was expectantly managed with an initial β-hCG of 585 mIU/mL until undetectable. This patient presented with ruptured ectopic pregnancy 8 weeks after the original diagnosis, at the level of 5 mIU/mL. This highlights the importance of close monitoring in the expectant management of tubal ectopic pregnancies, with the incorporation of imaging, even when serial β-hCG shows a persistently reducing trend.

Role of MRI in the early diagnosis of tubal ectopic pregnancy

2015 ◽  
Vol 26 (7) ◽  
pp. 1971-1980 ◽  
Author(s):  
Ming-Jue Si ◽  
Shuang Gui ◽  
Qin Fan ◽  
Hong-Xiu Han ◽  
Qian-Qian Zhao ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Ectopic Pregnancy ◽  
Tubal Ectopic Pregnancy

scholarly journals Clinical study of ectopic pregnancy at tertiary care center in Haryana, India

2019 ◽  
Vol 8 (7) ◽  
pp. 2816
Author(s):  
Sushila Chaudhary ◽  
Meenakshi B. Chauhan ◽  
Anjali Gupta ◽  
Monika Dalal
Keyword(s):  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Care Center ◽  
Tertiary Care ◽  
First Trimester ◽  
Sexual Practices ◽  
Care Hospital ◽  
Threatening Condition ◽  
Incidence Risk ◽  
Β Hcg

Background: Ectopic pregnancy is a life threatening condition in the first trimester of pregnancy. Diagnosis can be done by clinical examination, serum β-HCG and ultrasonography. This retrospective study was done to know the incidence, risk factors, and management of ectopic pregnancy.Methods: It was a retrospective study conducted on 75 patients of ectopic pregnancy admitted at tertiary care hospital in Haryana from February-2017 to January-2019. Data collected from record room and analysis done.Results: Total deliveries were conducted were 5064. The incidence of ectopic pregnancy was 1.48%, majority of the women were in the age group of 21-30 (68%), multi-parous (77.32%). The most common risk factor was abortion 33.33%, f/b tubal ligation was 13.13%, medical management of ectopic pregnancy done in 30.66%, 8% were managed by laproscopically and 58.66% by laparotomy.Conclusions: Safe sexual practices can reduce pelvic infections and ectopic pregnancy incidences. Early diagnosis before tubal rupture can reduce morbidity and mortality in ectopic pregnancy.

scholarly journals A Rare Case of Bilateral Tubal Ectopic Pregnancy Following Intracytoplasmic Sperm Injection-Embryo Transfer (ICSI-ET)

2020 ◽  
Vol 42 (03) ◽  
pp. 165-168
Author(s):  
Ferruh Acet ◽  
Ege Nazan Tavmergen Goker ◽  
Ismet Hortu ◽  
Gulnaz Sahin ◽  
Erol Tavmergen
Keyword(s):  
Ectopic Pregnancy ◽  
Embryo Transfer ◽  
Tubal Pregnancy ◽  
Serum Progesterone ◽  
Tubal Ectopic Pregnancy ◽  
Vitro Fertilization ◽  
Reproductive Techniques ◽  
History Of ◽  
Β Hcg

AbstractBilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in β-hCG values during the follow-up, 22 days after the embryo transfer, the β-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, β-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and β-hCG levels should be monitored.

The role of leukemia inhibitory factor in tubal ectopic pregnancy

Placenta ◽  
2013 ◽  
Vol 34 (11) ◽  
pp. 1014-1019 ◽  
Author(s):  
T. Krishnan ◽  
A. Winship ◽  
S. Sonderegger ◽  
E. Menkhorst ◽  
A.W. Horne ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Leukemia Inhibitory Factor ◽  
Inhibitory Factor ◽  
Tubal Ectopic Pregnancy

P–028 Single centre retrospective analysis of endocrine stimulation therapy prior to microsurgical testicular sperm retrieval (mTESE) in men with hypogonadism and non-obstructive azoospermia (NOA)

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
G Chiriaco ◽  
K Naylor ◽  
V Talaulikar ◽  
E Williamson ◽  
G Conway ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Success Rate ◽  
Retrospective Analysis ◽  
Klinefelter Syndrome ◽  
Serum Testosterone ◽  
Obstructive Azoospermia ◽  
Sperm Retrieval ◽  
Infertile Men ◽  
Before And After

Abstract Study question What is the role of endocrine stimulation therapy prior to mTESE in men with hypogonadism and non obstructive azoospermia (NOA)? Summary answer In hypogonadal men there is a positive correlation between change of serum Testosterone (ΔT) before and after stimulation, and a successful mTESE. What is known already NOA is the most common cause of azoospermia and it is often associated with hypogonadism and testicular failure. It is common practice for endocrine stimulation therapies such as gonadotropines or selective estrogens receptor modulators to be used prior mTESE; however there is currently paucity of data regarding their efficacy. Study design, size, duration Retrospective analysis on infertile men with hypogonadism (defined as T < 12nmol/L) and NOA who underwent mTESE with or without prior endocrine stimulation therapy (clomiphene or human chorionic gonadotropin). Retrospective data from 2015–2020, total number of patient: 71; stimulated group (N:40) vs unstimulated group (N:31). Participants/materials, setting, methods Retrospective study on infertile men who underwent mTESE with or without prior endocrine stimulation therapy. Hypogonadism was defined as serum testosterone (T) level <12nm/L. We recorded demographic data, cause of testicular failure, previous testosterone therapy, duration and type of endocrine stimulation, pre-and post-stimulation hormone levels(T, FSH, LH), pre-operative hormone levels, successful sperm retrieval rate (at least 1 vial of viable sperm), average Johnsen score and total number of vials of sperm retrieved. Main results and the role of chance One-hundred-sixty-eight men underwent mTESE out of which 59 men received endocrine stimulation therapy for NOA between 2015–2020. Among them, we selected men with hypogonadism defined as serum T < 12nmol/L which comprised 43% of the entire patient cohort. The hypogonadal group included 71 men, 28/71 had Klinefelter syndrome and 40/71 received endocrine stimulation for 13.9±9.2 months. Testosterone levels significantly increased after endocrine stimulation (6.3±3.3nm/L vs 11.7±7.4nm/L) with mean change in serum testosterone (ΔT) of 5.7 nm/L (–5.5–23.3, N35). In the stimulated group, pre-operative serum T levels were significantly higher (11.7±7.4 vs 7.8±3.0 p:0.007) as compared to unstimulated men but the success rate of mTESE did not differ significantly (16/40–40%) vs 13/31–42%). Men with Klinefelter syndrome demonstrated significant differences with regards to age, lower T levels, higher FSH and LH levels, lower Johnsen score and success rates compared to other causes of NOA. Comparing men who had successful mTESE vs unsuccessful mTESE - higher T and lower FSH and LH seemed to correlate with successful sperm retrieval. Among men who received endocrine stimulation therapy the ΔT before and after stimulation seemed to correlate with successful sperm retrieval (AUC:0.701, SE:0.089, p:0.043). In the stimulated group a ΔT>3.5nm/L showed a significant association with successful mTESE(p:0.041). Limitations, reasons for caution Retrospective study limitations. Wider implications of the findings: Our study shows a significant improvement of serum T following endocrine stimulation therapy. Overall, in hypogonadal men, the hormonal stimulation seems not to be related to a higher success rate of mTESE but our data do suggest a positive correlation between ΔT before and after stimulation, and a successful mTESE. Trial registration number Not applicable

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