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Clinical effectiveness of multiple-drug injection treatment in unruptured ectopic pregnancies: a retrospective study.
Dai, Quan; Wang, Lu-Lu; Shao, Xiao-Hui; Wang, Si-Ming; Dong, Xiao-Qiu.
Afiliação
  • Dai Q; Department of Ultrasonography, Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan St, 150001 Harbin, Heilongjiang Province, China.
J Ultrasound Med ; 31(10): 1627-34, 2012 Oct.
Article em En | MEDLINE | ID: mdl-23011626
ABSTRACT

OBJECTIVES:

To study the effect of local interventional treatment of unruptured ectopic pregnancies with multiple-drug injection guided by color Doppler sonography.

METHODS:

In this retrospective analysis, 49 patients with an unruptured ectopic pregnancy were treated with two different local injection methods administered under sonographic guidance. The patients were divided into single-drug (n = 23) and multiple-drug (n = 26) injection groups, and they received a locally administered injection of methotrexate alone or a combination including methotrexate, hemocoagulase, antibiotics, and anti-inflammatory drugs, respectively. Overall, local injection treatment was successful in 44 patients. The 5 patients with failed treatment underwent laparotomy about 1 week after single-drug injection. Serum ß-human chorionic gonadotropin (ß-hCG ) levels, ectopic pregnancy mass sizes, blood flow at various points after treatment, the incidence of pelvic bleeding, and the time for serum ß-hCG levels to return to normal and the mass to resolve were analyzed in the remaining 44 patients.

RESULTS:

Single-drug treatment was successful in 18 patients; 10 of 23 had low to moderate pelvic bleeding after treatment, and 5 were referred for surgery. All 26 patients were successfully treated by multiple-drug injection. Only 2 patients had a small amount of pelvic bleeding. Differences between groups were statistically significant (P < .05) for surgery rates, the incidence of pelvic bleeding, transient increases in serum ß-hCG levels, mean days to normal ß-hCG levels, mean days of mass resolution, and mean mass diameters 1 to 6 weeks after treatment.

CONCLUSIONS:

Local multiple-drug injection under color Doppler guidance is a new, safe, and effective method for treating unruptured ectopic pregnancies. It accelerates the serum ß-hCG decline and facilitates mass resolution. This regimen is associated with a very low rate of pelvic bleeding, improves the success rate of conservative treatment, and, therefore, has value as an important clinical application.
Assuntos
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Base de dados: MEDLINE Assunto principal: Gravidez Ectópica / Metotrexato / Ultrassonografia de Intervenção / Ultrassonografia Doppler em Cores Tipo de estudo: Guideline / Observational_studies / Risk_factors_studies Limite: Female / Humans / Pregnancy Idioma: En Revista: J Ultrasound Med Ano de publicação: 2012 Tipo de documento: Article País de afiliação: China
Buscar no Google
Base de dados: MEDLINE Assunto principal: Gravidez Ectópica / Metotrexato / Ultrassonografia de Intervenção / Ultrassonografia Doppler em Cores Tipo de estudo: Guideline / Observational_studies / Risk_factors_studies Limite: Female / Humans / Pregnancy Idioma: En Revista: J Ultrasound Med Ano de publicação: 2012 Tipo de documento: Article País de afiliação: China