Multiple dose methotrexate chemotherapy in suspected medical treament failure of ectopic pregnancy.
- Author:
Hyun Ju MIN
1
;
Sung Shik HAN
;
Jun Won CHOI
;
Sung Bin SON
;
Young Suk CHOI
;
Chul Min LEE
;
Bok Lin KIM
;
Hoon CHOI
;
Yong Kyoon CHO
;
Kyo Hoon PARK
;
Hong Kyoon LEE
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, Inje University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Multiple dose MTX chemotherapy;
Ectopic pregnancy
- MeSH:
Ascitic Fluid;
Drug Therapy*;
Female;
Fetal Heart;
Gynecology;
Humans;
Methotrexate*;
Obstetrics;
Odds Ratio;
Pregnancy;
Pregnancy, Ectopic*;
Risk Factors;
Treatment Failure
- From:Korean Journal of Obstetrics and Gynecology
2001;44(11):2073-2077
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The purpose of this study was to determine the efficacy of multiple dose methotrexate (MTX) chemotherapy approved as a primary treatment of ectopic pregnancy in suspected medical treatment failure of ectopic pregnancy. METHODS: This study included 77 hemodynamically stable high risk ectopic pregnants diagnosed from January 1995 to June 2000 at department of Obstetrics & Gynecology, Sanggye Paik hospital, Inje university. High risk criteria of our study were adnexal ectopic mass 3.5 cm or serum-hCG 4,000 mIU/ml or presence of fetal heart beat(FHB) or presence of peritoneal fluid and fresh blood on culdocentesis. Statistics were analyzed with 2-test, Student t-test and odds ratio of each risk factors. RESULTS: The response rate of multiple dose MTX chemotherapy was 85.7%(66/70). There was no statistically difference of risk factors between success and failure group except fetal heart beat. Among 11 failure patients, there were 3 patients with adnexal ectopic mass 3.5 cm (odds ratio=1.4, 0.3~5.7), 3 patients with presence of FHB, 7 patients with presence of peritoneal fluid(odds ratio=1.0, 0.3~3.8), 8 patients with serum-hCG 4,000 mIU/ml (odds ratio=2.8, 0.7~11.6). CONCLUSION: There results suggest that multiple dose MTX chemotherapy can be treated regardless of ectopic mass size, presence of pretoneal fluid, serum beta-hCG level. But we must pay attention to treat ectopic pregnancy with presence of fetal heart beat.
