INTRAVENOUS METHOTREXATE FOR THE TREATMENT OF UN-RUPTURED ECTOPIC PREGNANCY | ||||
| The Egyptian Journal of Fertility and Sterility | ||||
| Article 7, Volume 11, Issue 2, January 2007, Page 49-60 PDF (2.82 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2007.4889 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Hassan Awwad1; Nabeel Yamany1; M. Gad1; Hala Mousaa1; Widad Ouf2; Ibrahim Bedaiwy3; Khalid AlGhamdi4 | ||||
| 1Maternity and children hospital-Al-Madinah Al-Munawarah, | ||||
| 2Maternity and children hospital-Al-Madinah Al-Munawarah | ||||
| 3Department of Ob/Gyn-Ohud hospital - Al-Madinah Al-Munawarah | ||||
| 4Post-graduate studies- Department of family medicine -Al-Madinah Al-Munawarah | ||||
| Abstract | ||||
| Objectives: To evaluate the efficiency and safety of intravenous mctholrcxntc as an alternative to surgery for (he treatment of un-ruptured tubal pregnancy as well as cost effectiveness. Design: A cohort study. Setting: Madina Maternity and Children's Hospital (MMCH). Al Madinah Al Munawarah. KSA. Period from 9/02/2005 to 26/06/2006 (01/01/I426H to 30/05/1427H) Methods: The authors studied thirty four patients with un-ruptured tubal cciopic pregnancies, clinically stable, who were treated with intravenous methotrcxale according to a single-dose protocol. Prctrcalmcnl scrum concentrations of human chorionic gonadotrophin (hCG) and progesterone, cndovaginal ultrasonography to asses si/.e of the mass, fetal cardiac activity and the presence of fluid in the peritoneal cavity (presumably blood) were done. All were correlated with the efficiency of therapy as defined by resolution of cciopic pregnancy (decline in hCG level to 15 mlU/ml or less) without the need for surgical intervention. The outcome measures also included the frequency of preservation of the lubes, subsequent ipsilaleral tubal patency and further pregnancy within one year. Results: The success rate was 88.2%. Thirty four patients of forty one (34 of 41) diagnosed as cciopic pregnancy were treated with intravenous methotrcxate (82.9%). Twenty eight of thirty four (82.35%) were successfully treated with a single-dose intravenous mcthotrexatc. Six patients (17.65%) needed a second dose of methotrcxate. The mean scrum chorionic gonadotrophin and progesterone concentrations were 3247.53 mlU/ml ± SD 348.1 and 8.54 ±13.1 ng/ml respectivley. The mean time needed for serum hCG concentration to reach 15 mlU/ml or less (the resolution lime) was 35.1±SD 12.8 days. Subsequent pregnancy rate within one year was 69.2% (9 women of 13). Side effects to methotrcxate therapy were minimal. Conclusion: Single dose of intravenous methotrcxate therapy was well tolerated, cost-saving, non surgical, fallopian tube saving treatment for un-ruptured cciopic pregnancy | ||||
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