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Comparison of single-dose and two-dose methotrexate protocols for the treatment of unruptured ectopic pregnancy.
MedLine Citation:
PMID:  21534757     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Summary The purpose of this study was to compare the safety and success rates of single- and two-dose methotrexate (MTX) protocols for the treatment of unruptured tubal ectopic pregnancy. This retrospective study included 87 patients with ectopic pregnancy who were treated with MTX therapy (single-dose protocol: 46 patients; two-dose protocol: 41 patients). Both protocol groups were compared with regard to success rates, β-hCG and progesterone levels, the presence of cardiac activity, a history of previous ectopic pregnancy, ectopic mass size, gestational age, adverse events, and number of repeat MTX doses. Success rates between the single-dose and two-dose methotrexate therapy groups were comparable (87% vs 90.2%; OR 0.7, 95% CI 0.18-2.75; p = 0.74). No significant differences were found between the groups in factors influencing MTX treatment success rate, including the mean β-hCG level, mean progesterone level, the presence of a positive cardiac activity, mean ectopic mass size, mean endometrial thickness, and the presence of a yolk sac. There were also no significant between-group difference were found in the percentage of women who needed a repeat dose of MTX (17.3% vs 7.3%; OR 0.3, 95% CI 0.09-1.52; p = 0.20) and in the percentage of adverse events (45.7% vs 58.7%; OR 1.6, 95% CI 0.71-3.93; p = 0.28). In conclusion, medical treatment with single-dose or with two-dose systemic MTX seem to be equal therapeutic options for patients with unruptured ectopic pregnancy.
Authors:
K Gungorduk; O Asicioglu; G Yildirim; O Celikkol Gungorduk; B Besimoglu; C Ark
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology     Volume:  31     ISSN:  1364-6893     ISO Abbreviation:  J Obstet Gynaecol     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309140     Medline TA:  J Obstet Gynaecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  330-4     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Mardin Women and Children Hospital Mardin.
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