A medical management of interstitial ectopic pregnancy: A 5-year clinical study

Tang, A., Baartz, D. and Khoo, S. K. (2006) A medical management of interstitial ectopic pregnancy: A 5-year clinical study. Australian & New Zealand Journal of Obstetrics & Gynaecology, 46 2: 107-111.


Author Tang, A.
Baartz, D.
Khoo, S. K.
Title A medical management of interstitial ectopic pregnancy: A 5-year clinical study
Journal name Australian & New Zealand Journal of Obstetrics & Gynaecology  (ERA 2012 Listed)    (ERA 2010 Rank C)   Check publisher's open access policy
Publication date 2006
Sub-type Article
DOI 10.1111/j.1479-828X.2006.00537.x
Volume number 46
Issue number 2
ISSN 0004-8666
Start page 107
End page 111
Total pages 5
Editor M. Humphrey
Place of publication Carlton South, Australia
Publisher Blackwell Publishing Asia
Collection year 2006
Language eng
Subject C1
321014 Obstetrics and Gynaecology
730201 Women's health
Abstract Background: Medical treatment of the rare interstitial ectopic pregnancy with methotrexate has been considered an alternative to surgical resection. Aim: To determine the treatment success rate with a single-dose intravenous methotrexate/folinic acid regimen and to identify predictors of treatment outcome. Methods: A 5-year audit (April 2000-August 2005) was carried out, collecting clinical imaging data and serum beta-human chorionic gonadotrophin (beta-hCG). Time taken for complete beta-hCG resolution was recorded, and a negative beta-hCG result was used as an endpoint of successful outcome. Results: Of the 13 cases, two required urgent surgery for rupture on presentation. In the remaining 11 cases, intravenous methotrexate (300 mg) was used, with oral folinic acid rescue (15 mg x 4 doses). There were no side-effects. Complete beta-hCG resolution was achieved in 10 of the 11 medically treated cases (91% success rate), requiring 21-129 days. Successful outcome was seen with initial beta-hCG level as high as 106 634 IU/L and gestation sac as large as 6 cm and a live fetus. Conclusion: The methotrexate/folinic acid regimen used as a one-dose treatment is safe and effective for unruptured interstitial pregnancy, with no side-effects and the advantage of avoiding invasive surgery. Subsequent tubal patency and reproductive function are yet to be ascertained.
Keyword Obstetrics & Gynecology
Cornual Ectopic Pregnancy
Folinic Acid
Interstitial Pregnancy
Intravenous Methotrexate
Medical Management
Methotrexate Treatment
Dose Methotrexate
Predictors
Registry
Q-Index Code C1

 
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Created: Wed, 15 Aug 2007, 08:02:55 EST