Medical treatment of ectopic pregnancies: a randomized clinical trial comparing methotrexate-mifepristone and methotrexate-placebo

Rozenberg, Patrick; Chevret, Sylvie; Camus, E.; Tayrac, Renaud de; Garbin, O.; Poncheville, L. de; Coiffic, Jerry; Lucot, J P; Goueff, F. Le; Tardif, D; Allouche, C.; Fernandez, H.

doi:10.1093/humrep/deg344

Cited by 69 publications

(40 citation statements)

References 25 publications

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“…L'adjonction de 600 mg de mifépristone (RU486) au MTX intramusculaire n'augmenterait pas les chances de succès [10,11]. L'essai thérapeutique français [11] retrouve un avantage au RU486 dans le sous-groupe des GEU actives défi-nies par des taux de PG supérieurs à 10 ng/ml.…”

Section: Place De La Mifépristoneunclassified

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Prise en charge diagnostique et thérapeutique des grossesses extra-utérines

Gervaise

Fernandez

2010

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Section: Place De La Mifépristoneunclassified

“…L'essai thérapeutique français [11] retrouve un avantage au RU486 dans le sous-groupe des GEU actives défi-nies par des taux de PG supérieurs à 10 ng/ml.…”

Section: Place De La Mifépristoneunclassified

Prise en charge diagnostique et thérapeutique des grossesses extra-utérines

Gervaise

Fernandez

2010

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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“…Rozenberg shows that the effect of methotrexate decrease linearly when serum β-hCG level is increased 17 . Some investigators recommended surgical treatment when β-hCG level exceeds 40001U/m1 18 .…”

Section: Resultsmentioning

confidence: 99%

Medical Management of Ectopic Pregnancy: An Observational Study

Begum

Akhtar

2016

Bangladesh J Obstet Gynaecol

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Objectives: The aim of this study was to explore the safety and efficacy of medical management of ectopic pregnancy.Materials and methods: This prospective observational study was conducted between February 2011 to August 2013 in Chittagong Medical College Hospital (CMCH) and in different private clinics of Chittagong city. Twenty-seven patients of ectopic pregnancy conceived by fertility treatment were recruited for medical treatment after proper evaluation. Ectopic pregnancy was diagnosed by serum ?-hCG and progesterone level but missing intrauterine pregnancy by transabdominal sonography (TAS). Serum ?-hCG was repeated after 48 hours to observe doubling of the level. If level was not doubled or increment was not at least 66% and serum progesterone level was less than 15ng/ml then it was considered as ectopic pregnancy. Patients were treated with Injection methotrexate 50 mg intramuscularly either by single dose or two doses. After 4 days of 1st injection ?-hCG was repeated and if level decreased > 15% then patients were assessed weekly till ?-hCG fell to <5lU/L. If drop was <15% after 4 days a second dose of methotrexate was given.Results: Overall success rate was 66.66% . Surgical intervention was needed in 22.22% patients. All patients were treated after hospitalization in CMCH and different private clinics of Chittagong. They got injection methotrexate, antibiotic, antispasmodic and analgesics for abdominal pain. Single dose cured 55.55% patients and 11.11% patients needed second dose, another 11.11% patients were misdiagnosed later on they were diagnosed as intrauterine pregnancy and medical termination was done. Within one year of treatment 33.33% patients conceived again. There was no side effect or complications of the treatment.Conclusion: This small trial gave a good impression about medical treatment in selective cases. The efficacy should be assessed in a randomized clinical trial with a different set of populationBangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 32-36

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“…(Misme et al, 2015): intramuscular, "in situ" with ultrasound or "in situ" by laparoscopy at a dose of 1 mg / kg. Other molecules are also used, alone or in combination with methotrexate: KCl in situ (5 mmol) (especially in heterotopic pregnancies or in case of contraindication or failure of treatment with methotrexate), mifepristone when Initial progesteroneemia is greater than 9 ng / mL (Rozenberg et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

About a Case of Failure of Medical Treatment of an Interstitial Pregnancy

Ragmoun¹,

Daadoucha²,

Benhlima³

et al. 2017

ijccr

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Interstitial pregnancy is a rare entity that accounts for nearly 2% of ectopic pregnancies. His diagnosis is almost always based on laparoscopy. The risk of rupture with significant hemorrhage remains high. The treatment is classically surgical by corneal resection, medical treatment is increasingly used. Through an observation of an interstitial pregnancy diagnosed in our department and treated initially medically and then by radical surgery and by means of a review of the literature, we will try to explain the different diagnostic and therapeutic methods used in interstitial pregnancies, we will also learn the importance of patient selection in order to avoid risky changes, especially in the absence of consensus.

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Medical treatment of ectopic pregnancies: a randomized clinical trial comparing methotrexate-mifepristone and methotrexate-placebo

Cited by 69 publications

References 25 publications

Prise en charge diagnostique et thérapeutique des grossesses extra-utérines

Prise en charge diagnostique et thérapeutique des grossesses extra-utérines

Medical Management of Ectopic Pregnancy: An Observational Study

About a Case of Failure of Medical Treatment of an Interstitial Pregnancy

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