Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy
Obstetrics & Gynecology Science
; : 571-578, 2017.
Article
em En
| WPRIM
| ID: wpr-126351
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE:
To examine the therapeutic outcomes of methotrexate (MTX) in the treatment of unruptured interstitial pregnancy.METHODS:
We reviewed the medical records of patients who were diagnosed with interstitial pregnancy and received MTX as first-line treatment between January 2003 and July 2014 at CHA Gangnam Medical Center. The treatment success rates and subsequent pregnancy outcomes were examined.RESULTS:
Ninety-seven patients were diagnosed with interstitial pregnancy between January 2003 and July 2014. Of them, 38 initially received MTX treatment. The diagnosis was made at a median of 6+3 weeks (5+0 to 11+3 weeks). Thirty patients received a systemic MTX injection, while the other 8 received a local MTX injection. Systemic treatment composed of an 8-day alternating MTX regimen, single-dose regimen, or high-dose regimen (100 mg/m2 + 200 mg/m2 intravenously over 12 hours). The local injection consisted of a direct MTX injection into the gestational sac with or without systemic MTX injection. Twenty-one patients (55.3%) were successfully treated with MTX. However, MTX therapy failed in 17 patients (44.7%), who required surgery. Mode of MTX treatment was the only predictive variable of MTX treatment success (P=0.039). Treatment success was seen in 7 of 8 patients (87.5%) in the local MTX group vs. 14 of 30 patients (46.7%) in the systemic MTX group. After treatment, 13 patients attempted a successive pregnancy; of them, 10 patients had a confirmed clinical pregnancy and healthy live birth.CONCLUSION:
Combined MTX treatment including a local injection might be an initial approach to the treatment of interstitial pregnancy.Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Complicações na Gravidez
/
Resultado da Gravidez
/
Metotrexato
/
Prontuários Médicos
/
Diagnóstico
/
Nascido Vivo
/
Saco Gestacional
/
Gravidez Intersticial
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Obstetrics & Gynecology Science
Ano de publicação:
2017
Tipo de documento:
Article