États des lieux et expertise de l’usage hors AMM du méthotrexate en gynécologie–obstétrique : travail du CNGOF

Marret, H.; Fauconnier, A.; Dubernard, Gil; Misme, H.; Lagarce, Laurence; Lesavre, M.; Fernandez, H.; Mimoun, Camille; Tourette, Claire; Curinier, S.; Rabishong, B.; Agostini, Aubert

doi:10.1016/j.sagf.2015.04.003

Cited by 2 publications

(6 citation statements)

References 31 publications

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“…Ectopic pregnancy is a major gynecological emergency. The therapeutic aspects are a subject of controversy, especially for medical treatment with Methotrexate [3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Most French studies do not recommend a medical treatment for EP on a living embryo [3]. We report two cases of EP with live embryos that have received medical treatment.…”

Section: Introductionmentioning

confidence: 89%

“…In indications and contraindications for the medical treatment of ectopic pregnancy, there is no consensus [3,8]. Currently, the points of discussion lie in the relative contraindications that are the maximum permissible levels of plasma β-HCG and progesterone as well as certain ultrasound criteria such as the presence of a cardiac activity and a hemoperitoneum [1,3,[9][10][11]. In Africa, ectopic pregnancy is most often diagnosed at the stage of tubal rupture with peritoneal flood [2,7].…”

Section: Therapeutic Aspects Treatment Indicationsmentioning

confidence: 99%

“…The multiple-dose regimen, especially in the United States, includes 4 doses of Methotrexate at 1 mg / kg intramuscularly on days 1, 3, 5, and 7 and 0.1 mg / kg of folinic acid [3,15,17].…”

Section: Therapeutic Protocolsmentioning

confidence: 99%

“…The limitations of this protocol are hospitalization, financial cost, and side effects such as stomatitis, leukopenia, nausea, abdominal pain, alopecia, and elevated liver enzymes. The single-dose regimen used mainly in Europe and some African countries is administered at the dosage of 1 mg / kg or 50 mg / m 2 [3,18,19].…”

Section: Therapeutic Protocolsmentioning

confidence: 99%

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Medical Treatment of Tubar Ectopic Pregnancy with Living Embryo: About Two Cases in Dakar (Senegal)

Gassama¹,

Biaye²,

Niass³

et al. 2019

Gynecol Reprod Health

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Objectives: To evaluate the efficacy of treatment with methotrexate, and the possibility of medical treatment of living embryo. Observation: We report two cases in secondary amenorrhea of 6 weeks received in an algebra table associated with minimal bleeding. The physical examination had found moderate pain in the left iliac fossa for the first patient and for the second patient in the right iliac fossa with minimal bleeding. The first endo-vaginal ultrasound showed a left lateral uterine mass, the second one a right lateral uterine mass containing a living embryo of six-week amenorrhea. We administered a triple dose of methotrexate to both patients whose improvement could be noticed trough a clinical remission and a decrease of the plasmatic βHCG level. Consequently, we decided to release them after 8 days of hospitalization. Conclusion: The medical treatment of tubal ectopic pregnancy with living embryo is difficult due to the work conditions; furthermore, it is a controversial issue in our country.

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“…Ectopic pregnancy is a major gynecological emergency. The therapeutic aspects are a subject of controversy, especially for medical treatment with Methotrexate [3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Most French studies do not recommend a medical treatment for EP on a living embryo [3]. We report two cases of EP with live embryos that have received medical treatment.…”

Section: Introductionmentioning

confidence: 89%

Section: Therapeutic Aspects Treatment Indicationsmentioning

confidence: 99%

“…The multiple-dose regimen, especially in the United States, includes 4 doses of Methotrexate at 1 mg / kg intramuscularly on days 1, 3, 5, and 7 and 0.1 mg / kg of folinic acid [3,15,17].…”

Section: Therapeutic Protocolsmentioning

confidence: 99%

Section: Therapeutic Protocolsmentioning

confidence: 99%

See 3 more Smart Citations

Medical Treatment of Tubar Ectopic Pregnancy with Living Embryo: About Two Cases in Dakar (Senegal)

Gassama¹,

Biaye²,

Niass³

et al. 2019

Gynecol Reprod Health

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Methotrexate Treatment of Ectopic Pregnancy: Prognosis at Senlis Hospital

Logbo-Akey¹,

M’bortche²,

Kambote³

et al. 2022

OJOG

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Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient if it is ignored. Diagnosed early, it offers the possibility of medical treatment with methotrexate. Objective: To describe the prognosis of ectopic pregnancies treated methotrexate. Patients and Methods: Retrospective study of the management of ectopic pregnancy by Methotrexate at Senlis hospital from June 2020 to May 2021 were included in the study, patients with a Fernandez score of less than 13, and having received Methotrexate as first-line treatment. Data were collected using gynecological emergency admission registers, and telephone interviews. Results: 35 cases were identified. The average age of the patients was 32 years old. Forty-nine percent were smokers. The mean gestational age was 5 weeks + 2 days. The diagnosis was made in all of our patients with the combination of the kinetics of ß-hcg and vaginal ultrasound. The size of adnexal mass was less than 4 cm with an average size of 20 mm. The average value of ß-hcg was 1405 IU/L. All patients had received a single dose of methotrexate 1 mg/kg intramuscularly. A second dose was administered to 17.1% of patients for stagnation or re-ascension of the ß-hcg level. The success rate was 91.4%. Thirty percent were obtained spontaneous intra uterine pregnancy, the first year following methotrexate treatment. Conclusion: The success rate of medical treatment for ectopic pregnancy is high in terms of meeting the eligibility criteria for treatment. The subsequent prognosis of fertility is generally preserved.

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États des lieux et expertise de l’usage hors AMM du méthotrexate en gynécologie–obstétrique : travail du CNGOF

Cited by 2 publications

References 31 publications

Medical Treatment of Tubar Ectopic Pregnancy with Living Embryo: About Two Cases in Dakar (Senegal)

Medical Treatment of Tubar Ectopic Pregnancy with Living Embryo: About Two Cases in Dakar (Senegal)

Methotrexate Treatment of Ectopic Pregnancy: Prognosis at Senlis Hospital

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