Predictors of Success of Medical Management of Ectopic Pregnancy in a Tertiary Care Hospital in United Arab Emirates

Vaswani, Pooja Rajesh

doi:10.7860/jcdr/2014/8152.4712

Cited by 6 publications

(13 citation statements)

References 20 publications

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“…6 In another study by Vaswani, 54.6% patients had primary surgery and in the study by Bonin, 57.2% patients were treated with primary surgical therapy. 7,8 These figures are comparable to our study. Delay in first visit to doctor after pregnancy confirmation is probably the reason for the higher percentage of ruptured ectopic pregnancy in this part of North India.…”

Section: Discussionsupporting

confidence: 91%

“…Similar results were documented in various studies by Vaswani, Bonin, Potter and Ustunyurt. 7,8,14,15 There was an average fall in Day 4 HCG levels in one dose group as compared to two dose or unsuccessful group where a rise was documented. Tthis was also observed in some similar studies.…”

Section: Discussionmentioning

confidence: 90%

“…[7][8][9][10][11] These studies vary widely in-patient selection and cut offs for HCG values (10,000 or more) and dose protocols (single dose versus multidose). Present study had more strict criteria for patient selection compared to these studies, which may have contributed to better outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Success of medical management of tubal ectopic pregnancy with Methotrexate in a tertiary hospital in North India

Juneja

Jain

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Unruptured ectopic pregnancy can be managed with surgery as well as systemic methotrexate. We aimed to study efficacy of medical management and factors affecting success in strictly selected patients.Methods: It was a three-year prospective observational study. 171 patients with ectopic pregnancy were screened and those fulfilling the strict study criteria were given systemic methotrexate. The single dose regimen was followed. Patients were observed for side effects and signs of rupture. Serial measurement of HCG levels was done to determine success or failure. Various factors were studied which had potential bearing on results.Results: Thirty-one patients received methotrexate. We had an overall success rate of 93%. Two of the participants had surgery due to failure. No major side effects were observed.Conclusions: Carefully selected patients of unruptured ectopic pregnancy can be safely and successfully treated with systemic methotrexate.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 90%

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Success of medical management of tubal ectopic pregnancy with Methotrexate in a tertiary hospital in North India

Juneja

Jain

2018

Int J Reprod Contracept Obstet Gynecol

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“…20,21 Based on our findings number of cases with decreasing β-hCG level on day 4 was significantly more in the success group compared to the failure group (62.5% and 36.9% respectively, p<0.0001).) similar to Ustunyurt et al (61.9 and 37.5%, respectively) Nguyen et al, Vaswani et al, and Skubisz et al 3,12,21,22 .…”

Section: Discussionsupporting

confidence: 83%

“…Late diagnosis leads to rupture and cause internal hemorrhage 1 . Today, due to scientific, laboratory and imaging technologies advances, EP diagnosed at an early stage with transvaginal ultrasonography and serum Beta-human chorionic gonadotropin (BHCG) assay 2,3 . Compared to previous treatment, although instead of laparotomy, laparoscopy is preferred, medical treatment with methotrexate (MTX) seems to be more attractive to doctors.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Medical Treatment Success in Ectopic Pregnancy with Single Dose Methotrexate: 5 Year Experience

Yıldız¹,

Doğan²

2017

Kafkas J Med Sci

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(62.5% and 36.9% respectively, p<0.0001). The success rate was 95% when the levels were <1000 mIU/ml, 87.5% when the levels were between 1000-1999 mIU/ml and 35.5% when the levels were >5000 mIU/ml. Conclusion:Medical treatment with single dose systemic MTX may be an acceptable therapeutic option for ectopic pregnancy and MTX therapy is a safe and effective treatment modality for ectopic pregnancies with a serum BHCG levels below 3000 mIU/ml.

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Predictive Factors of Methotrexate Treatment Success in Ectopic Pregnancy: A Single Tertiary Center Study

Pulatoğlu

Doğan

Başbuğ

et al. 2017

North Clin Istanbul

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OBJECTIVE:It is controversial whether medical or surgical treatment options have more successful results in ectopic pregnancy treatment. Although high pretreatment serum hCG levels have been known to be the most important predictor, the appropriate treatment modality for a specific range of hCG level remains unclear. Furthermore, the variables that make a patient a bad candidate for single-dose methotrexate treatment is unclear. The aim of this study was to identify predictive factors associated with the success of single-dose methotrexate treatment in women with ectopic pregnancy.METHODS:In this retrospective study, 101 women with tubal ectopic pregnancies who had been treated with single-dose methotrexate were selected. The gestational ages, pretreatment hCG values, ectopic mass size, and fluid presence in the abdomen were compared between the groups.RESULTS:The mean age of the patients was 30.6±5.8 (range, 19–42) years, and the gestational age at first injection was 7.0±2.13 (range, 2.3–13.6) weeks. The overall treatment success rate was 77.2% (n=79). The mean duration of hospital stay was 4.21±1.89 days in the successfully treated group and 6.92±2.13 days in the failure group (p<0.05). The rate of treatment failure in patients with abdominal fluid was 37.8%, and it was 12.7% in the non-fluid group (p=0.03). hCG values on days 1, 4, and 7 were significantly higher in the unsuccessful group (3887–2589 mIU/mL, 2814–1287 mIU/mL, and 1119–285 mIU/mL, respectively; p<0.05). The cutoff hCG value, which determined the failure of methotrexate treatment, was found to be 1362 mIU/mL.CONCLUSION:In present study, patients with hCG value <1362 mIU/mL were found to be good candidates for methotrexate treatment. Although not strictly decisional, this hCG threshold level can be used to decide on the likelihood of methotrexate success or failure. Detection of abdominal fluid on ultrasonography also can be assessed as a bad prognostic factor, but size of ectopic mass does not correlate with methotrexate treatment success.

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Predictors of Success of Medical Management of Ectopic Pregnancy in a Tertiary Care Hospital in United Arab Emirates

Cited by 6 publications

References 20 publications

Success of medical management of tubal ectopic pregnancy with Methotrexate in a tertiary hospital in North India

Success of medical management of tubal ectopic pregnancy with Methotrexate in a tertiary hospital in North India

Evaluation of Medical Treatment Success in Ectopic Pregnancy with Single Dose Methotrexate: 5 Year Experience

Predictive Factors of Methotrexate Treatment Success in Ectopic Pregnancy: A Single Tertiary Center Study

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