The efficacy and prognostic factors of methotrexate treatment in cervical/previous cesarean scar pregnancy.
- Author:
Joon Cheol PARK
1
;
Jeong Ho RHEE
;
Jong In KIM
Author Information
1. Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Daegu, Korea. jcpark@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Cervical/previous cesarean scar pregnancy;
Methotrexate
- MeSH:
Cicatrix*;
Female;
Fertility;
Gestational Age;
Hematoma;
Humans;
Methotrexate*;
Parity;
Pregnancy*;
Retrospective Studies
- From:Korean Journal of Obstetrics and Gynecology
2006;49(5):1028-1034
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To evaluate the efficacy and prognostic factors of methotrexate treatment in cervical/previous cesarean scar pregnancy. METHODS: This study was retrospectively performed in 25 women who had diagnosed cervical/previous cesarean scar pregnancy. Clinical and demographic characteristics, methotrexate regimen, concomitant invasive procedures, complications, and outcomes were analyzed. RESULTS: Among the 25 cases, 64% of women was succeeded by only methotrexate injection, and 96% of women could preserved her fertility after concomitant procedures. There were no significant differences in the patients' age, parity, gestational age and serum beta-hCG, but significant differences in methotrexate administration route and presence of initial hematoma formation between success group and failure group of methotrexate therapy. A concomitant feticide could enhance the therapeutic effect. CONCLUSIONS: The presence of hematoma formation before treatment is important predictor of methotrexate treatment in cervical/previous cesarean scar pregnancy, rather than gestational age, serum beta-hCG. And direct local injection of methotrexate with concomitant feticide procedure could be better route of administration in cervical/previous cesarean scar pregnancy.
