A medical management of interstitial ectopic pregnancy: a 5-year clinical study

The Australian & New Zealand Journal of Obstetrics & Gynaecology
Amy TangSoo Keat Khoo

Abstract

Medical treatment of the rare interstitial ectopic pregnancy with methotrexate has been considered an alternative to surgical resection. To determine the treatment success rate with a single-dose intravenous methotrexate/folinic acid regimen and to identify predictors of treatment outcome. A 5-year audit (April 2000-August 2005) was carried out, collecting clinical imaging data and serum beta-human chorionic gonadotrophin (beta-hCG). Time taken for complete beta-hCG resolution was recorded, and a negative beta-hCG result was used as an endpoint of successful outcome. Of the 13 cases, two required urgent surgery for rupture on presentation. In the remaining 11 cases, intravenous methotrexate (300 mg) was used, with oral folinic acid rescue (15 mg x 4 doses). There were no side-effects. Complete beta-hCG resolution was achieved in 10 of the 11 medically treated cases (91% success rate), requiring 21-129 days. Successful outcome was seen with initial beta-hCG level as high as 106 634 IU/L and gestation sac as large as 6 cm and a live fetus. The methotrexate/folinic acid regimen used as a one-dose treatment is safe and effective for unruptured interstitial pregnancy, with no side-effects and the advantage of avoiding invasive surge...Continue Reading

References

Jan 1, 1993·Gynecologic and Obstetric Investigation·R TalmonJ Itskovitz-Eldor
Aug 10, 1999·Fertility and Sterility·S Lau, T Tulandi
May 16, 2003·American Journal of Obstetrics and Gynecology·Megan B PotterDenise J Jamieson
Aug 13, 2003·Acta Obstetricia Et Gynecologica Scandinavica·Louis Yik-Si ChanPong Mo Yuen
Jan 6, 2004·Obstetrics and Gynecology·Togas Tulandi, Dania Al-Jaroudi
Jan 10, 2004·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Lisa VerityJan E Dickinson
Jan 13, 2004·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Soo-Keat Khoo
Jun 26, 2004·Journal of Chemotherapy·E PeritiG Amunni
Nov 4, 2004·BJOG : an International Journal of Obstetrics and Gynaecology·Karen JermyTom Bourne

❮ Previous
Next ❯

Citations

Aug 8, 2009·Clinical Obstetrics and Gynecology·Stacey Ehrenberg-BuchnerWilliam W Hurd
Jun 30, 2009·Journal of Human Reproductive Sciences·R RastogiV Rastogi
Dec 19, 2015·Gynécologie, obstétrique & fertilité·K NikodijevicJ Boujenah
Aug 28, 2012·Annals of Emergency Medicine·Sigrid A HahnUNKNOWN American College of Emergency Physicians Clinical Policies Subcommittee on Early Pregnancy
May 1, 2010·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Andrea TinelliDaniel Alberto Tsin
Aug 18, 2009·The American Journal of Emergency Medicine·Karen Gaber-Patel, Michael D Smith
Feb 24, 2009·Best Practice & Research. Clinical Obstetrics & Gynaecology·Mohammed Agdi, Togas Tulandi
Mar 20, 2016·Journal de gynécologie, obstétrique et biologie de la reproduction·E DebrasP Capmas
Jun 9, 2012·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Xulei ZuoMeixin Chen
Apr 15, 2015·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Keisuke TanakaSoot Keat Khoo
Mar 12, 2010·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Soo-Keat KhooLee Tripcony
Jun 14, 2014·Journal of Clinical Ultrasound : JCU·Marialuisa Framarino-dei-MalatestaGabriele Masselli
Oct 24, 2014·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Liran HierschYoav Peled
Apr 11, 2015·Medical Journal, Armed Forces India·Nikita NarediV D S Jamwal
Jan 26, 2010·American Journal of Obstetrics and Gynecology·Nash S MoawadWilliam W Hurd
Sep 28, 2010·Fertility and Sterility·Xiao-Jun YangFei-Yun Zheng
Feb 11, 2015·Journal de gynécologie, obstétrique et biologie de la reproduction·H MismeC Tourette
Nov 5, 2016·BJOG : an International Journal of Obstetrics and Gynaecology
Jul 14, 2012·São Paulo Medical Journal = Revista Paulista De Medicina·Nilson Abrão SzylitRita de Cassia Sanches Oliveira
Mar 15, 2018·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Semih Zeki UludagOzguc Altun
Nov 13, 2018·Journal of Obstetrics and Gynaecology of India·Mamta DagarDeepak Chawla
Nov 26, 2010·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Jiaoe PanJunmei Wang
May 8, 2021·Curēus·Oluwatofunmi Oshodi, Jose Castaneda
Nov 14, 2006·Current Opinion in Obstetrics & Gynecology

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.