Predictors of Success of Different Treatment Modalities for Management of Ectopic Pregnancy

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.

A retrospective analysis of ectopic pregnancies in tertiary care hospital of Western India: two year study

“…In the present study, salpingectomy (laparoscopy or laparotomy) was performed in 74.3% cases which is similar to that found in a study carried out by Sümeyra et al (74.4%). 15 The rate of laparotomy (85%) was higher than the laparoscopy (15%) which is in consistent with Sümeyra et al 15 Obstetric hysterectomy was performed in 1 case of CSP following dilatation and evacuation due to uncontrolled and torrential haemorrhage. There have been many reasons for the increased rate of laparotomy in comparison to laparoscopy in the present research.…”

“…Salpingo-oophorectomy was done in 2.8% cases (ruptured ovarian ectopic) in present study which correlated to Sümeyra et al (4.6%). 15 One case abdominal pregnancy (gestational age-26 weeks) was diagnosed per-operatively and was successfully managed by removal of fetus and placenta, which was implanted over posterior aspect of right sided broad ligament and was separated successfully. Management of placenta in abdominal pregnancy remains a controversial issue.…”

Gefitinib and Methotrexate to Treat Ectopic Pregnancies with a Pre-Treatment Serum hCG 1000–10,000 IU/L: Phase II Open Label, Single Arm Multi-Centre Trial

“…Using A'Hern's formula for Phase II one-stage designs [ 8 ], with 80% power and a 5% level of significance, 28 patients were required to enable us to assess whether the proportion of patients with a successful outcome to treatment was >70%. The reason we selected this figure is that methotrexate in the clinic appears to have a success rate of around 70% [ 9 , 10 ]. Our power calculation found if 24 or more patients have a successful outcome, we can reject the hypothesis that the true efficacy of combination gefitinib and methotrexate is ≤70%.…”

Methotrexate in Unruptured Ectopic Pregnancy: Comparing the Single- and Double-dose Treatment

“…Besides, Avcıuoglu et al in 2014 (30) reported no significant difference between single-dose (70.14% of treatment success) and double-dose (70%) regimen. They also depicted that in β-hCG levels<1000 IU/L, treatment success rises up to 86.11%, while in β-hCG levels>3000 IU/L treatment success was limited to 42.3%.…”