Evaluation of Methotrexate as a Medical Treatment in Cesarean Scar Ectopic Pregnancy Five Years' Experience of Ain Shams Maternity Hospital
Mohamed Mahmoud Mohamed Ramadan;
Abstract
Abstract
Objective: To evaluate efficacy of methotrexate therapy in treatment of
cesarean scar ectopic pregnancy.
Design: A retrospective descriptive study.
Setting: At Ain Shams University Maternity Hospital within the last five years.
Subjects: Eleven cases already diagnosed as cesarean scar pregnancies of
4-9 weeks gestational age from LMP.
Methods: Medical treatment consisted of 1 mg/kg methotrexate, 75 mg
total, intramuscular, day 1 was the day that MTX was administered and
basal hCG was measured, on Day 7, a serum hCG concentration was
drawn. There was a decrease in hCG less than 15 percent, so
a second dose of MTX 50 mg/m2 IM was given. An additional 3
dose of
MTX was given and no repeating of pretreatment laboratory testing
(complete blood count, renal and liver function tests) was required, hCG
testing was repeated weekly after each dose.
Outcome measure: Succecceful medical treatment was considered when
there was a ≥15 percent hCG decline between weekly measures.
Results: The level of BHCG at base line was 7705.7±1466.1, and
decrease insignificantly at time 1 to be 7019.8±1439.7, at second time the
level of BHCG was decreased significantly to be 4496.5±1800.4, finally at
end of follow up the level of BHCG was significantly decreased to be
2964.4±897.3.
It was found that there was a positive significant correlation between
BHCG level (mIU/ml) at end of follow up and BHCG level at base line
after methotrexate injection.
So our study demonstrates that the use of systemic methotrexate therapy
results in significant reduction of the level of BHCG level in the eleven
diagnosed patients of cesarean scar ectopic pregnancy within the last five
years at Ain Shams maternity hospital (P> 0.05).
Conclusion: The present study demonstrated that the use of systemic
methotrexate injection is effective in management of 4-9 weeks cesarean
scar ectopic pregnancy management decreasing maternal morbidity and
mortality regarding other invasive surgical lines of treatment.
rd
Objective: To evaluate efficacy of methotrexate therapy in treatment of
cesarean scar ectopic pregnancy.
Design: A retrospective descriptive study.
Setting: At Ain Shams University Maternity Hospital within the last five years.
Subjects: Eleven cases already diagnosed as cesarean scar pregnancies of
4-9 weeks gestational age from LMP.
Methods: Medical treatment consisted of 1 mg/kg methotrexate, 75 mg
total, intramuscular, day 1 was the day that MTX was administered and
basal hCG was measured, on Day 7, a serum hCG concentration was
drawn. There was a decrease in hCG less than 15 percent, so
a second dose of MTX 50 mg/m2 IM was given. An additional 3
dose of
MTX was given and no repeating of pretreatment laboratory testing
(complete blood count, renal and liver function tests) was required, hCG
testing was repeated weekly after each dose.
Outcome measure: Succecceful medical treatment was considered when
there was a ≥15 percent hCG decline between weekly measures.
Results: The level of BHCG at base line was 7705.7±1466.1, and
decrease insignificantly at time 1 to be 7019.8±1439.7, at second time the
level of BHCG was decreased significantly to be 4496.5±1800.4, finally at
end of follow up the level of BHCG was significantly decreased to be
2964.4±897.3.
It was found that there was a positive significant correlation between
BHCG level (mIU/ml) at end of follow up and BHCG level at base line
after methotrexate injection.
So our study demonstrates that the use of systemic methotrexate therapy
results in significant reduction of the level of BHCG level in the eleven
diagnosed patients of cesarean scar ectopic pregnancy within the last five
years at Ain Shams maternity hospital (P> 0.05).
Conclusion: The present study demonstrated that the use of systemic
methotrexate injection is effective in management of 4-9 weeks cesarean
scar ectopic pregnancy management decreasing maternal morbidity and
mortality regarding other invasive surgical lines of treatment.
rd
Other data
| Title | Evaluation of Methotrexate as a Medical Treatment in Cesarean Scar Ectopic Pregnancy Five Years' Experience of Ain Shams Maternity Hospital | Other Titles | تقييم لمدى فاعلية استخدام عقار الميثوتريكسات في علاج الحمل خارج الرحم فوق ندبة قيصرية سابقة بمستشفى النساء و التوليد جامعة عين شمس في الخمس سنوات الأخيرة | Authors | Mohamed Mahmoud Mohamed Ramadan | Issue Date | 2018 |
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