Ectopic pregnancy treatment by combination therapy

Abstract

<jats:title>Abstract</jats:title><jats:p>Detectability of early stages of ectopic pregnancies has increased due to improvements in ultrasonographic and biochemical techniques. Since the patients’ future procreative plans must be taken into consideration when commencing treatment, the goal of this work was to compare the effects of treatment methods and their impact on fertility. The study included 91 patients treated surgically for ectopic pregnancy. The choice of treatment depended on patients’ general condition, ultrasonographic evaluation and serum level of beta-hCG. A combination of laparoscopic and conservative systemic treatment was applied in 70% of cases. More rapid beta-hCG reduction was noted when laparoscopy and intra-oviductal injection of hyperosmolar glucose or methotrexate (MTX) were combined with intramuscular administration of MTX at a dose of 50 mg/m2. Follow-up examination of 66 patients revealed that the greatest number of spontaneous pregnancies (48%) resulted after this combination therapy. We conclude that this combination treatment is safe and provides satisfactory results in terms of future fertility.</jats:p>

Comparison between laparoscopic surgery and laparotomy for the treatment of acute ruptured ectopic pregnancy

“…Acute ruptured ectopic pregnancy can cause a large amount of bleeding and blood volume loss, which will affect the blood perfusion of liver, kidney and other important organs and increase the risk of viscera function damage [5][6]. In clinical practice, the timely emergency operation can avoid further development of bleeding and ensure the safety of the patient's life.…”

Identifying the deceiver: the non-neoplastic mimickers of genital system neoplasms

“…Findings were considered consistent with in utero ovarian torsion. Her recovery was uneventful and she was discharged 6 days after the surgery glucose, NaCl or KCl administration may be preferred over surgical exploration to preserve the future fertility [91,92]. Additionally, endovascular embolization may be a helpful precautionary intervention for gaining control of uterine arteries in case of a hemorrhagic complication (Fig.…”

“…However, it is important to keep in mind the possibility of an EP as it can change patient management. In suspected cases of EP, combination of more conservative approaches such as systemic methotrexate treatment, uterine artery embolization, and image-guided local methotrexate, prostaglandin, hyperosmolar glucose, NaCl or KCl administration may be preferred over surgical exploration to preserve the future fertility [ 91 , 92 ]. Additionally, endovascular embolization may be a helpful precautionary intervention for gaining control of uterine arteries in case of a hemorrhagic complication (Fig.…”

Ectopic Pregnancy

“…Regarding medical management, Methotrexate was first perceived as a potential treatment for unruptured EP in 1982 and is being used successfully for treatment of EP as an alternative to surgery. [4][5][6] There are 3 treatment regimens of Methotrexate available: the multi-dose conventional treatment, one dose treatment and 2-dose treatment. 7,8 The objective of this study was to assess the success rate of single dose of Methotrexate for medical management of females presenting with EP.…”