Comparison of a local injection of hyperosmolar glucose solution with salpingostomy for the conservative treatment of tubal pregnancy

Laatikainen, Timo; Tuomivaara, Leena; Käär, K.

doi:10.1016/s0015-0282(16)56040-3

Cited by 24 publications

(7 citation statements)

References 14 publications

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“…Laparoscopic salpingostomy has been compared with methotrexate injected laparoscopically, [14][15][16] with methotrexate injected transvaginally, 17 and with hyperosmolar glucose injected laparoscopically. 18 However, the comparison of a complete non-surgical and non-invasive treatment by the systemic administration of methotrexate with laparoscopic salpingostomy was lacking until our randomised clinical trial.…”

Section: Discussionmentioning

confidence: 99%

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Hajenius

Engelsbel

Mol³

et al. 1997

The Lancet

240

115

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General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Interpretation In haemodynamically stable patients with unruptured tubal pregnancy, systemic methotrexate and laparoscopic salpingostomy were successful in treating the majority of cases. We found no significant difference between the treatments in the homolateral patency rate. Subsequent fertility outcome has to be awaited to show which treatment yields better fertility prospects.

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Section: Discussionmentioning

confidence: 99%

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Hajenius

Engelsbel

Mol³

et al. 1997

The Lancet

240

115

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“…Laparoscopically guided injections may be done with a needle guided through a 5-mm trocar or via a spinal needle. 16,54,55 The technique is similar to the injection of vasopressin used during surgical treatment of an ectopic pregnancy. Although readily available, a spinal needle may be technically difficult to guide to the ectopic, especially in an obese woman and/or a patient in which the tube cannot be delivered to the needle.…”

Section: Laparoscopymentioning

confidence: 99%

“…The ability to aspirate the sac fluid and inject the medication accurately into the sac may be limited compared with a TVUS approach, given the lack of US guidance, and the medication may be delivered inadvertently into the pregnancy-induced hematoma or otherwise miss the ectopic. 54…”

Section: Laparoscopymentioning

confidence: 99%

“…Laatikainen et al 54 prospectively randomly assigned 40 women with unruptured tubal pregnancies in which no FH was present and the hCG level was < 5000 IU/L to laparoscopic treatment with either hyperosmolar glucose (10 to 20 cm 3 of a 50% glucose solution) or linear salpingostomy via a monopolar needle. hCG levels decreased more slowly in the glucose arm, with a similar mean time to resolution of 13 and 12 days in the glucose and salpingostomy arms, respectively.…”

Section: Laparoscopic Injection Versus Linear Salpingostomymentioning

confidence: 99%

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Local Treatment of Ectopic Pregnancy

Raughley

Frishman²

2007

Semin Reprod Med

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The treatment of ectopic pregnancies has evolved from a purely surgical route with routine removal of the fallopian tube to one with multiple options. Medical treatment can be administered systemically or via local injection. Local delivery of chemotherapeutic agents is a safe and proven modality that is especially indicated for pregnancies in which a laparoscopic approach is not ideal and systemic therapy either has failed or is not desired. Local therapy has the potential to document immediately the cessation of fetal heart activity. Nontubal ectopic pregnancies may be ideally suited to local therapy, especially when there is a fetal heart present. Transvaginal ultrasound is the preferred mode for guidance and laparoscopic guidance has a limited role. Although a multitude of agents have been proposed, methotrexate, KCl, and hyperosmolar glucose are the most widely used and readily available. Local therapy has an important place in the armamentarium of the treatment of ectopic pregnancies.

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“…Medical management avoids the inherent morbidity of anaesthesia and surgery and reduce costs. Methotrexate, Potassium chloride, hyperosmolar glucose, Actinomysin D and Prostaglandins have been used successfully to treat ectopic pregnancy 11,12 . Methotrexate (MTX) has been established as an effective first line medical therapeutic alternative to surgical treatment.…”

mentioning

confidence: 99%

Safety and Efficacy of Methotrexate In Unruptured Ectopic Pregnancy

Forhad¹,

Begum

Alam

et al. 2016

Bangladesh J Obstet Gynaecol

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Introduction: Ectopic pregnancy is disaster in human reproduction. It is one of the most important causes of death during 1 st trimester of pregnancy. Ectopic pregnancy is more threatening for women than normal vaginal delivery and induced abortion 2 . Timely diagnosis and appropriate treatment can reduce the risk of maternal mortality and morbidity related to ectopic pregnancy 3 . If not diagnosed and treated expediously it may also take the life of the mother or at the very least, compromise her future ability to reproduce. Although it has been recognized for over 400 years, ectopic pregnancy continues to be an ever increasing affliction, affecting approximately 2% of all pregnancies 4 . The rising incidence of ectopic pregnancy in the past 25 years has been attributed to a number of factors like tubal surgery and tubal ligation, previous ectopic pregnancy, IUCD use, tubal pathology, morning after pill, assisted reproductive technique(ART), salpingitis, genital tract infection and the treatment has progressed from salpingectomy by laparotomy to conservative surgery by laparoscopy and more recently to medical therapy 5,6 . With Original Articles

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Comparison of a local injection of hyperosmolar glucose solution with salpingostomy for the conservative treatment of tubal pregnancy

Cited by 24 publications

References 14 publications

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Local Treatment of Ectopic Pregnancy

Safety and Efficacy of Methotrexate In Unruptured Ectopic Pregnancy

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