Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Hajenius, P. J.; Engelsbel, Simone; Mol, Ben Willem J.; Veen, Fulco van der; Ankum, W. M.; Bossuyt, Patrick M.; Hemrika, D. J.; Lammes, F. B.

doi:10.1016/s0140-6736(97)05487-1

Cited by 240 publications

(144 citation statements)

References 18 publications

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“…By analysing the tubal preservation, we did not find a statistically significant difference in the preservation of the fallopian tubes in women who received salpingostomy 45/49 (91.8%) compared to women who received medical treatment with systemic methotrexate 46/51 (90.2%) MTX [14]. The same study also examined the ipsilateral tubal patency, showing 23/39 (59%) of patent ipsilateral tubes in women who received surgical treatment and 23/42 (54.8%) for women who received medical treatment with systemic methotrexate.…”

Section: Discussionmentioning

confidence: 64%

“…Among the analysed studies, five trials were conducted in the US, two in Egypt and France and the others in Finland, Iran, New Zealand, Sweden, Netherlands and the United Kingdom. Comparing systemic methotrexate treatment in multiple dose regimen and laparoscopic salpingostomy, a multicentre study found a nonsignificant trend toward greater success of drug treatment [14].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the success rate, a five-study meta-analysis found no statistically significant difference in the success rate in women who received surgical treatment (87%) compared to women who received medical treatment with methotrexate (79.3%) [14,20,21,23,24].…”

Section: Discussionmentioning

confidence: 99%

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Drug treatment versus surgical treatment for tubal ectopic pregnancy: an integrative review

Cruz¹,

Matos²,

Bezerra³

et al. 2016

Int Arch Med

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

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Drug treatment versus surgical treatment for tubal ectopic pregnancy: an integrative review

Cruz¹,

Matos²,

Bezerra³

et al. 2016

Int Arch Med

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“…Subsequent intrauterine pregnancy rates were 83.5 and 81%, respectively [13]. Another randomised trial comparing systemic methotrexate or laparoscopic salpingostomy demonstrated comparable ipsilateral tubal patency rates (55 vs 59%) [14].…”

Section: Medical Management Of Tubal Ectopic Pregnancymentioning

confidence: 97%

The management of ectopic pregnancies and pregnancies of unknown location

2004

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Since the introduction of dedicated Early Pregnancy Units and the use of high-resolution transvaginal probes ectopic pregnancies are diagnosed at earlier gestations. As a result, the treatment options in the management of ectopic pregnancies have diversified. In this review, the role of transvaginal sonography in the management of women with ectopic pregnancies is described and the different treatment modalities available in their management are critically evaluated. We assert that ectopic pregnancy should be diagnosed on the basis of positively visualising an adnexal mass using transvaginal sonography, rather than the absence of an intrauterine pregnancy. If a pregnancy cannot be seen, either inside or outside the uterus, this should be described as a pregnancy of unknown location and managed expectantly until the outcome is confirmed.

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“…La finalidad de preservar la integridad tubárica es a costa de un mayor riesgo de trofoblasto persistente, definido como concentraciones séricas de β-HCG en aumento o estables después del tratamiento conservador inicial, para el cual se requiere un tratamiento adicional (quirúrgico o médico) (7)(8)(9)(10)(11).…”

Section: Introductionunclassified

Rol De La Cirugía Endoscópica en El Manejo Actual Del Embarazo Ectópico Tubárico

G¹,

P²

2005

Rev. chil. obstet. ginecol.

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RESUMENSe presenta una experiencia local de cirugía laparoscópica en el embarazo ectópico tubárico, y basado en la literatura, se discute su rol actual entre diferentes tipos de tratamiento: el quirúrgico, el médico, y la conducta expectante. Se analizan los efectos de estos regímenes en función del éxito del tratamiento, la necesidad de reintervención, la permeabilidad tubárica y fertilidad futura. PALABRAS CLAVE: Embarazo ectópico tubárico SUMMARYWe report our experience in laparoscopy surgery in the treatment of tubal pregnancy. Various types of treatments are available: surgical, medical and expectant management. In this review the effects of various treatment are summarized in terms of treatment success, need for reinterventions, tubal patency and future fertility. KEY WORDS: Ectopic tubal pregnancy Trabajos Originales INTRODUCCIÓNLa incidencia del embarazo ectópico tubárico (EET) ha ido en aumento durante las últimas dé-cadas. Esto es debido al advenimiento de los métodos anticonceptivos y la liberación sexual de la mujer que, juntos, llevaron a un incremento en los casos de enfermedad inflamatoria pélvica (EIP) y trajo como una de sus consecuencias el EET. Además del incremento de la EIP, las cirugías de trompas y otros procedimientos para tratar la infertilidad contribuyeron sobremanera con este aumento (1).En la actualidad el médico cuenta con muchas opciones terapéuticas para el EET: el tratamiento quirúrgico, que puede ser radical o conservador, por laparoscopia o mediante laparotomía; tratamiento médico, con diversos fármacos, que se pueden administrar por vía sistémica o local, y la conducta expectante.El diagnóstico de embarazo ectópico se puede hacer con métodos no invasivos, como las pruebas de embarazo en suero, con cuantificación de subunidad beta de gonadotropina coriónica humana (β-HCG), desde 1500 UI/l, y con ultrasonido transvaginal de alta resolución. Por consiguiente, la presentación clínica del embarazo ectópico ha dejado de ser una amenaza para la vida de la mujer, para convertirse en una patología más benigna; esto a su vez, ha dado como resultado cambios importantes en las opciones disponibles para su manejo terapéutico (2-4).La cirugía conservadora es el procedimiento de elección para pacientes que deseen una fertilidad futura, definida como el tiempo transcurrido desde el EET hasta un embarazo intrautrauterino

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Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Cited by 240 publications

References 18 publications

Drug treatment versus surgical treatment for tubal ectopic pregnancy: an integrative review

Drug treatment versus surgical treatment for tubal ectopic pregnancy: an integrative review

The management of ectopic pregnancies and pregnancies of unknown location

Rol De La Cirugía Endoscópica en El Manejo Actual Del Embarazo Ectópico Tubárico

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