Prognostic accuracy of a novel methotrexate protocol for the resolution of tubal ectopic pregnancies

Leonardi, Mathew; Allison, Eleanor; Lü, Chuan; Nadim, B.; Condous, G.

doi:10.1016/j.ejogrb.2020.02.029

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…6 Many studies have shown increased treatment failure of SD rather than MD. [7][8][9] Also, the success rate of treatment with MD is higher than with DD but MD causes a considerable increase in creatinine. 10 The available literature on the medical management of EP is scant and limited to a few parameters related to the management protocols.…”

Section: Introductionmentioning

confidence: 99%

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Predictive value of serum βHCG level in ectopic pregnancy: A cross sectional study

Ghanaie,

Hoshyarmanesh,

Asgari

et al. 2023

Health Science Reports

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Background and AimsEctopic pregnancy (EP) is a potentially life‐threatening emergency. We investigate the predictive value of serum βHCG level and it's changes from the baseline to the 4th and 7th days after single dose (SD) methotrexate (MTX) treatment in successful treatment of tubal EP. It is important for early diagnosis of EP.MethodsIn this cross‐sectional study, 690 women with tubal EP and under treatment with SD MTX were evaluated. Successful and failed groups were analyzed on the baseline, 4th and 7th days of MTX treatment. Data were analyzed using SPSS22 software. All p values of less than 0/05 were considered satistically significant.ResultsSD MTX treatment was successful in 584 (84.7%) patients. The mean baseline ßHCG value was 882.35 ± 430.76 in the successful group and 1083.99 ± 1080.25 in the failed group. There was a 19.53% decrease in ßHCG values between the baseline and 4th days in the successful group and a 12.94% increase in the failed group (p < 0.001). On days baseline, 4 and 7; receiver operating characteristic curve analysis's value was 504.5, 429, 279 for cut off; 58%, 73%, 81% for sensitivity and 51%, 52%, 55% for specificity, respectively.ConclusionA decrease in the ßHCG value and/or a cut‐off decrease of 59.9% on the baseline, 4th day and 81.6% between the baseline and 7th days, can predict the successful treatment of tubal EP with SD MTX.

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Section: Introductionmentioning

confidence: 99%

“…To date, the advantages of the different protocols were unclear due to a lack of comparative studies, but according to a recently published meta‐analysis, the DD protocol is more successful than the SD protocol 6 . Many studies have shown increased treatment failure of SD rather than MD 7–9 …”

Section: Introductionmentioning

confidence: 99%

Predictive value of serum βHCG level in ectopic pregnancy: A cross sectional study

Ghanaie,

Hoshyarmanesh,

Asgari

et al. 2023

Health Science Reports

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“…7,8 There are rare cases where the embryo implants in unusual sites like the cervix, ovary, or abdomen, making diagnosis and treatment more challenging. 9 Ectopic pregnancies also have a molecular dimension involving interleukins (ILs), which are cytokines with immunomodulatory functions. Studies indicate that levels of IL-6 and IL-8 are significantly elevated in the fallopian tubes near the implantation site during an ectopic pregnancy, affecting local tissue behavior and possibly contributing to the DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20234075 1 Department of Obstetrics and Gyecology, Baghdad Health Directorate-Al-Karkh, Baghdad, Iraq 2 Department of Obstetrics and Gynecology, Al-Nahrain University, College of Medicine, Baghdad, Iraq abnormal implantation.…”

Section: Introductionmentioning

confidence: 99%

Relationship of IL-6 and IL-8 levels with tubal ectopic pregnancy

Kadhim,

Khazaali

2023

Int J Reprod Contracept Obstet Gynecol

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Background: The frequency of ectopic pregnancy (EP) has increased worldwide during the last 30 years, particularly in underdeveloped countries with low early diagnostic rates. Ectopic pregnancy is the major cause of first-trimester deaths. Interleukins are immunomodulatory cytokines that modulate inflammatory responses and help humans conceive. Aim of the study was to evaluate the predictive value of interleukin-6 and interleukin-8 in tubal ectopic pregnancy. Methods: This case control research was undertaken in the Department of Obstetrics and Gynaecology at Al-Emamein Al-Kadhemein Medical City/Baghdad from January 1, 2022 to January 1, 2023. The study analysed 30 patients with missed cycles, positive β-HCG tests, vaginal bleeding, and ruptured tubal ectopic pregnancy diagnosed via transvaginal ultrasound (group A) and 30 patients with intrauterine missed miscarriage (group B). The control group (group C) included 30 ladies with uncomplicated intrauterine pregnancies of matched gestational age. Results: Interleukin-6 was substantially greater in ectopic pregnancy than miscarriage and normal intrauterine pregnancy. Ectopic pregnancy and miscarriage had higher levels of interleukin-8 than normal intrauterine pregnancy, but there was no difference. Interleukin-6 levels ≥76.1 pg/ml were linked to 90% sensitivity and 85% specificity in predicting ectopic pregnancy. Interleukin-8 was neither sensitive nor specific for ectopic pregnancy. Conclusions: Measurement of IL-6 may have a predictive value in cases of ruptured tubal ectopic pregnancy. IL-8 was a poor predictor for ectopic pregnancy.

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A novel methotrexate protocol for the resolution of tubal ectopic pregnancies: Methodological issues on prognostic studies

Sabour

2020

European Journal of Obstetrics & Gynecology and Reproductiv

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Prognostic accuracy of a novel methotrexate protocol for the resolution of tubal ectopic pregnancies

Cited by 5 publications

References 25 publications

Predictive value of serum βHCG level in ectopic pregnancy: A cross sectional study

Predictive value of serum βHCG level in ectopic pregnancy: A cross sectional study

Relationship of IL-6 and IL-8 levels with tubal ectopic pregnancy

A novel methotrexate protocol for the resolution of tubal ectopic pregnancies: Methodological issues on prognostic studies

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