| Efficacy and safety of single-dose systemic methotrexate in the treatment of ectopic pregnancy. | |
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MedLine Citation:
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PMID: 7926078 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the safety and efficacy of single-dose systemic methotrexate (MTX) in the treatment of ectopic pregnancy (EP). DESIGN: A database was started and continued prospectively for 35 patients meeting criteria for MTX therapy from June 1991 to October 1993. Follow-up was performed retrospectively on all patients with EPs (n = 82) by evaluating hospital and clinic records and by contacting affiliated physicians and individual patients. SETTING: The University of Vermont Reproductive Endocrinology Service. INTERVENTIONS: Methotrexate 50 mg/m2 was administered IM; blood samples were collected on days 0, 4, and 7 of MTX therapy and weekly thereafter until hCG titers became < 4 mIU/mL. RESULTS: Thirty-five of 82 (42.7%) patients diagnosed with EP were treated with MTX. The mean hCG concentration on day of treatment was 1388.1 +/- 463.5 (+/- SE) mIU/mL, and mean time to complete resolution of hCG was 23.1 +/- 2.9 days. Thirty of 35 (85.7%) were successfully treated with a single dose of MTX. Five of 35 (14.3%) failed therapy and required laparoscopic surgery. Twelve of 35 (34.3%) experienced mild side effects that resolved spontaneously. Ten of 13 (76.9%) demonstrated tubal patency at follow-up hysterosalpingogram. Of the 15 patients seeking pregnancy, 3 of 15 (20.0%) conceived, resulting in 3 term deliveries and 2 spontaneous abortions. CONCLUSIONS: Our results support the use of single-dose systemic MTX for the treatment of unruptured EP in carefully selected patients. |
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Authors:
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J L Glock; J V Johnson; J R Brumsted |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Fertility and sterility Volume: 62 ISSN: 0015-0282 ISO Abbreviation: Fertil. Steril. Publication Date: 1994 Oct |
Date Detail:
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Created Date: 1994-11-01 Completed Date: 1994-11-01 Revised Date: 2004-11-17 |
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: 716-21 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, University of Vermont College of Medicine, Burlington 05405. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Chorionic Gonadotropin / blood Dose-Response Relationship, Drug Female Humans Laparoscopy Methotrexate / administration & dosage*, adverse effects, therapeutic use Pelvic Pain / etiology Pregnancy Pregnancy Outcome Pregnancy, Ectopic / complications, drug therapy*, surgery Prospective Studies Treatment Failure Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Chorionic Gonadotropin; 59-05-2/Methotrexate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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