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Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience

Objective Our aim is to demonstrate the importance of methotrexate (MTX) therapy for the treatment of ectopic pregnancy (EP). Methods This retrospective study consisted of 99 patients (72 tubal EPs, 20 pregnancies of unknown location (PUL), 4 cesarean section (CS) scar EPs and 3 cervical EPs) treate...

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Autores principales: Ozyuncu, Ozgur, Tanacan, Atakan, Duru, Sinem Ayse, Beksac, Mehmet Sinan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316905/
https://www.ncbi.nlm.nih.gov/pubmed/30485898
http://dx.doi.org/10.1055/s-0038-1675807
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author Ozyuncu, Ozgur
Tanacan, Atakan
Duru, Sinem Ayse
Beksac, Mehmet Sinan
author_facet Ozyuncu, Ozgur
Tanacan, Atakan
Duru, Sinem Ayse
Beksac, Mehmet Sinan
author_sort Ozyuncu, Ozgur
collection PubMed
description Objective Our aim is to demonstrate the importance of methotrexate (MTX) therapy for the treatment of ectopic pregnancy (EP). Methods This retrospective study consisted of 99 patients (72 tubal EPs, 20 pregnancies of unknown location (PUL), 4 cesarean section (CS) scar EPs and 3 cervical EPs) treated with MTX. Results Methotrexate therapy was successful in 68.5% of EPs. There were statistically significant differences between the MTX success and failure groups based on ultrasonographic findings, patient complaints, gestational week and serum human chorionic gonadotropin (hCG) values. The MTX success rates in PUL and tubal pregnancies were 95% and 61.1%, respectively. The MTX success rates in single-dose, two-dose and multi-dose protocol groups were 86.9%, 28.6% and 40%, respectively. All cervical and CS scar ectopic pregnancies were treated successfully with MTX therapy. Conclusion Methotrexate might be the first-line treatment option for EPs under certain conditions. Physicians must be more cautious in cases with higher hCG values, the presence of abdominal-pelvic pain, the presence of fetal cardiac activity, larger gestational sac (GS) diameters, and more advanced gestational weeks according to the last menstrual period.
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spelling pubmed-103169052023-07-27 Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience Ozyuncu, Ozgur Tanacan, Atakan Duru, Sinem Ayse Beksac, Mehmet Sinan Rev Bras Ginecol Obstet Objective Our aim is to demonstrate the importance of methotrexate (MTX) therapy for the treatment of ectopic pregnancy (EP). Methods This retrospective study consisted of 99 patients (72 tubal EPs, 20 pregnancies of unknown location (PUL), 4 cesarean section (CS) scar EPs and 3 cervical EPs) treated with MTX. Results Methotrexate therapy was successful in 68.5% of EPs. There were statistically significant differences between the MTX success and failure groups based on ultrasonographic findings, patient complaints, gestational week and serum human chorionic gonadotropin (hCG) values. The MTX success rates in PUL and tubal pregnancies were 95% and 61.1%, respectively. The MTX success rates in single-dose, two-dose and multi-dose protocol groups were 86.9%, 28.6% and 40%, respectively. All cervical and CS scar ectopic pregnancies were treated successfully with MTX therapy. Conclusion Methotrexate might be the first-line treatment option for EPs under certain conditions. Physicians must be more cautious in cases with higher hCG values, the presence of abdominal-pelvic pain, the presence of fetal cardiac activity, larger gestational sac (GS) diameters, and more advanced gestational weeks according to the last menstrual period. Thieme Revinter Publicações Ltda 2018-11 /pmc/articles/PMC10316905/ /pubmed/30485898 http://dx.doi.org/10.1055/s-0038-1675807 Text en https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Ozyuncu, Ozgur
Tanacan, Atakan
Duru, Sinem Ayse
Beksac, Mehmet Sinan
Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience
title Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience
title_full Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience
title_fullStr Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience
title_full_unstemmed Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience
title_short Methotrexate Therapy for Ectopic Pregnancies: A Tertiary Center Experience
title_sort methotrexate therapy for ectopic pregnancies: a tertiary center experience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316905/
https://www.ncbi.nlm.nih.gov/pubmed/30485898
http://dx.doi.org/10.1055/s-0038-1675807
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AT tanacanatakan methotrexatetherapyforectopicpregnanciesatertiarycenterexperience
AT durusinemayse methotrexatetherapyforectopicpregnanciesatertiarycenterexperience
AT beksacmehmetsinan methotrexatetherapyforectopicpregnanciesatertiarycenterexperience