| Conservative medical and surgical management of interstitial ectopic pregnancy. | |
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MedLine Citation:
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PMID: 10438980 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To review the definition and diagnosis of interstitial and heterotopic interstitial pregnancy and to evaluate the conservative management of these conditions. DESIGN: A MEDLINE computer search was used to identify relevant studies. The mean values for the duration of amenorrhea, serum beta-hCG level, size of the ectopic mass, and success rates of the various treatment modalities were calculated from the raw data in the original publications. RESULT(S): A review of 41 patients with interstitial pregnancy who were treated with methotrexate systemically, locally, or in combination revealed an overall success rate of 83%. The mean duration of amenorrhea, mean serum beta-hCG level, and mean size of the ectopic mass were 54 days, 15,127 mIU/mL, and 23 mm, respectively. Among 22 patients with interstitial pregnancy who were treated with conservative laparoscopic techniques, the overall success rate was 100%. In this group, the mean duration of amenorrhea, mean serum beta-hCG level, and mean size of the ectopic mass were 54 days, 7,572 mIU/mL, and 31 mm, respectively. There were nine cases of heterotopic interstitial pregnancy. Seven patients were managed with potassium chloride injected into the ectopic pregnancy, and two patients were treated by laparoscopy. Overall, 67% of the coexisting intrauterine pregnancies resulted in successful deliveries and the remainder ended in spontaneous abortions. CONCLUSION(S): Cornual resection or hysterectomy with a laparotomy should no longer be the first line of treatment for a hemodynamically stable patient with an interstitial pregnancy. In selected cases, methotrexate and laparoscopy can be used successfully in treating early interstitial pregnancy. |
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Authors:
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S Lau; T Tulandi |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Fertility and sterility Volume: 72 ISSN: 0015-0282 ISO Abbreviation: Fertil. Steril. Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-08-30 Completed Date: 1999-08-30 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 207-15 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortifacient Agents, Nonsteroidal
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therapeutic use Female Humans Incidence MEDLINE Methotrexate / therapeutic use Pregnancy Pregnancy Complications Pregnancy, Ectopic / epidemiology, surgery, therapy* United States Uterine Rupture |
| Chemical | |
Reg. No./Substance:
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0/Abortifacient Agents, Nonsteroidal; 59-05-2/Methotrexate |
| Comments/Corrections | |
Comment In:
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Fertil Steril. 2000 May;73(5):1063-4
[PMID:
10866510
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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