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Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy
OBJECTIVE: To examine the therapeutic outcomes of methotrexate (MTX) in the treatment of unruptured interstitial pregnancy. METHODS: We reviewed the medical records of patients who were diagnosed with interstitial pregnancy and received MTX as first-line treatment between January 2003 and July 2014...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694732/ https://www.ncbi.nlm.nih.gov/pubmed/29184866 http://dx.doi.org/10.5468/ogs.2017.60.6.571 |
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author | Kim, Myung Joo Cha, Jae-Ho Bae, Hyo Sook Kim, Mi Kyoung Kim, Mi-La Yun, Bo Sung Kim, You Shin Seong, Seok Ju Jung, Yong Wook |
author_facet | Kim, Myung Joo Cha, Jae-Ho Bae, Hyo Sook Kim, Mi Kyoung Kim, Mi-La Yun, Bo Sung Kim, You Shin Seong, Seok Ju Jung, Yong Wook |
author_sort | Kim, Myung Joo |
collection | PubMed |
description | OBJECTIVE: To examine the therapeutic outcomes of methotrexate (MTX) in the treatment of unruptured interstitial pregnancy. METHODS: We reviewed the medical records of patients who were diagnosed with interstitial pregnancy and received MTX as first-line treatment between January 2003 and July 2014 at CHA Gangnam Medical Center. The treatment success rates and subsequent pregnancy outcomes were examined. RESULTS: Ninety-seven patients were diagnosed with interstitial pregnancy between January 2003 and July 2014. Of them, 38 initially received MTX treatment. The diagnosis was made at a median of 6(+3) weeks (5(+0) to 11(+3) weeks). Thirty patients received a systemic MTX injection, while the other 8 received a local MTX injection. Systemic treatment composed of an 8-day alternating MTX regimen, single-dose regimen, or high-dose regimen (100 mg/m(2) + 200 mg/m(2) intravenously over 12 hours). The local injection consisted of a direct MTX injection into the gestational sac with or without systemic MTX injection. Twenty-one patients (55.3%) were successfully treated with MTX. However, MTX therapy failed in 17 patients (44.7%), who required surgery. Mode of MTX treatment was the only predictive variable of MTX treatment success (P=0.039). Treatment success was seen in 7 of 8 patients (87.5%) in the local MTX group vs. 14 of 30 patients (46.7%) in the systemic MTX group. After treatment, 13 patients attempted a successive pregnancy; of them, 10 patients had a confirmed clinical pregnancy and healthy live birth. CONCLUSION: Combined MTX treatment including a local injection might be an initial approach to the treatment of interstitial pregnancy. |
format | Online Article Text |
id | pubmed-5694732 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-56947322017-11-28 Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy Kim, Myung Joo Cha, Jae-Ho Bae, Hyo Sook Kim, Mi Kyoung Kim, Mi-La Yun, Bo Sung Kim, You Shin Seong, Seok Ju Jung, Yong Wook Obstet Gynecol Sci Original Article OBJECTIVE: To examine the therapeutic outcomes of methotrexate (MTX) in the treatment of unruptured interstitial pregnancy. METHODS: We reviewed the medical records of patients who were diagnosed with interstitial pregnancy and received MTX as first-line treatment between January 2003 and July 2014 at CHA Gangnam Medical Center. The treatment success rates and subsequent pregnancy outcomes were examined. RESULTS: Ninety-seven patients were diagnosed with interstitial pregnancy between January 2003 and July 2014. Of them, 38 initially received MTX treatment. The diagnosis was made at a median of 6(+3) weeks (5(+0) to 11(+3) weeks). Thirty patients received a systemic MTX injection, while the other 8 received a local MTX injection. Systemic treatment composed of an 8-day alternating MTX regimen, single-dose regimen, or high-dose regimen (100 mg/m(2) + 200 mg/m(2) intravenously over 12 hours). The local injection consisted of a direct MTX injection into the gestational sac with or without systemic MTX injection. Twenty-one patients (55.3%) were successfully treated with MTX. However, MTX therapy failed in 17 patients (44.7%), who required surgery. Mode of MTX treatment was the only predictive variable of MTX treatment success (P=0.039). Treatment success was seen in 7 of 8 patients (87.5%) in the local MTX group vs. 14 of 30 patients (46.7%) in the systemic MTX group. After treatment, 13 patients attempted a successive pregnancy; of them, 10 patients had a confirmed clinical pregnancy and healthy live birth. CONCLUSION: Combined MTX treatment including a local injection might be an initial approach to the treatment of interstitial pregnancy. Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 2017-11 2017-10-24 /pmc/articles/PMC5694732/ /pubmed/29184866 http://dx.doi.org/10.5468/ogs.2017.60.6.571 Text en Copyright © 2017 Korean Society of Obstetrics and Gynecology http://creativecommons.org/licenses/by-nc/3.0/ Articles published in Obstet Gynecol Sci are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Myung Joo Cha, Jae-Ho Bae, Hyo Sook Kim, Mi Kyoung Kim, Mi-La Yun, Bo Sung Kim, You Shin Seong, Seok Ju Jung, Yong Wook Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy |
title | Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy |
title_full | Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy |
title_fullStr | Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy |
title_full_unstemmed | Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy |
title_short | Therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy |
title_sort | therapeutic outcomes of methotrexate injection in unruptured interstitial pregnancy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694732/ https://www.ncbi.nlm.nih.gov/pubmed/29184866 http://dx.doi.org/10.5468/ogs.2017.60.6.571 |
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