Document Detail


Prognostic factors for an unsatisfactory primary methotrexate treatment of cervical pregnancy: a quantitative review.
MedLine Citation:
PMID:  9806299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the risks when the primary methotrexate (MTX) treatment of cervical pregnancy has an unsatisfactory outcome, we conducted a Medline search on relevant literature published from January 1983 to June 1997. The search yielded 28 publications of 48 cases of cervical pregnancy. These and four new cases from our institutions were used in our study. A cervical pregnancy that presented with a serum beta-human chorionic gonadotrophin concentration of > or = 10,000 mIU/ml [odds ratio (OR) 10.82, 95% confidence interval (CI) 2.59, 45.14], gestational age at > or = 9 weeks (OR 6.44, 95% CI 1.46, 28.52), embryonic cardiac activity (OR 14.29, 95% CI 2.95, 76.92), and crown-rump length of >10 mm (OR 13.33, 95% CI 1.46, 120.48) was considered to be associated with a higher unsatisfactory rate of primary MTX treatment. A concomitant feticide was found to enhance the therapeutic effect of MTX treatment if embryonic cardiac activity was evident (OR 0.13, 95% CI 0.02, 0.68). Administration of a high dose of MTX did not seem to be more effective than a lower one. Our findings supported some previous observations and, more importantly, provided useful clinical information in selecting appropriate candidates for MTX treatment in cases of cervical pregnancy.
Authors:
T H Hung; W Y Shau; T T Hsieh; J J Hsu; Y K Soong; C J Jeng
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  13     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1999-01-21     Completed Date:  1999-01-21     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  2636-42     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / therapeutic use*
Adult
Cervix Uteri*
Female
Humans
Methotrexate / therapeutic use*
Middle Aged
Pregnancy
Pregnancy, Ectopic / drug therapy*,  physiopathology
Prognosis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 59-05-2/Methotrexate

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


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