Document Detail


Conservative medical and surgical management of interstitial ectopic pregnancy.
MedLine Citation:
PMID:  10438980     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S Lau; T Tulandi
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Fertility and sterility     Volume:  72     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-08-30     Completed Date:  1999-08-30     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  207-15     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / 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:
0/Abortifacient Agents, Nonsteroidal; 59-05-2/Methotrexate
Comments/Corrections
Comment In:
Fertil Steril. 2000 May;73(5):1063-4   [PMID:  10866510 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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