Predictors of success of different treatment modalities for management of ectopic pregnancy.

Sümeyra Nergiz Avcioğlu,Sündüz Özlem Altinkaya,Hasan Yüksel,Mert Küçük,Selda Demircan Sezer

doi:10.1155/2014/423708

Sümeyra Nergiz Avcioğlu, Sündüz Özlem Altinkaya + Show 3 more

Open Access

https://doi.org/10.1155/2014/423708

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Abstract

Aim. The purpose of this study was to investigate factors affecting the success of different treatment modalities for the management of ectopic pregnancy (EP). Methods. One hundred and ninety-seven patients with EP, were included in the study. Patients were treated with either intramuscular methotrexate (Mtx) or surgical treatment. Results. Mtx was applied in 97 (49.2%) patients. In 67 patients (69.1%), a single dose of Mtx and in 30 patients (30.9%) a multiple dose of Mtx was applied. Forty-seven (70.14%) patients were successfully treated with a single-dose Mtx. In the multiple-dose group, the success rate was 70% (21/30 patients). The difference between the success rates was not statistically significant. When the initial serum βhCG value was <1000 mIU/mL, the overall success rate of Mtx treatment was determined to be 86.11%; however, the rate decreased to 42.3% when the βhCG value was >3000 mIU/mL. On the other hand, if the EP mass diameter was <25 mm, the success rate was 89.28% and decreased to 52.63% when it was ≥25 mm. Conclusion. The results of the study showed that single-dose treatment with Mtx could be as successful as multiple doses. Overall success of Mtx treatment depended on initial βhCG value and EP mass diameter.

Highlights

Ectopic pregnancy (EP) is a potentially life-threatening condition and still the major cause of maternal mortality in the first trimester of pregnancy
We aimed to investigate the predictors related to the success of different treatment modalities for EP
Surgical intervention was performed in cases of tubal rupture and in patients whose βhCG levels decreased by less than 15% or a plateau was reached in serum βhCG after Mtx treatment doses

Summary

Introduction

Ectopic pregnancy (EP) is a potentially life-threatening condition and still the major cause of maternal mortality in the first trimester of pregnancy. It accounts for approximately 10% of maternal deaths [1]. Preserving the fertility of women has been the main goal of treatment in EP for gynecologists and over the last five years systemic methotrexate (Mtx) has been used for conservative treatment [9, 10]. In recent studies on single-dose Mtx therapy, tubal patency rates have been reported in excess of 80% and this is thought to be appropriate for preserving the fertility of patients [11]. We aimed to investigate the predictors related to the success of different treatment modalities for EP

Materials and Methods

Results

Discussion