Document Detail


Transvaginal intra-amniotic injection of methotrexate in early ectopic pregnancy. Advantages over the laparoscopic approach.
MedLine Citation:
PMID:  7875101     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Methotrexate (MTX, 100 mg) was administered to 36 patients with early ectopic pregnancy locally, either under laparoscopic control into the distended fallopian tube (group A, n = 16), or transvaginally into the gestational sac directly, under ultrasound guidance (group B, n = 20). In cases with persistent beta-hCG levels (n = 7), an additional 50 mg of MTX solution was instilled into the affected tube, following transuterine tubal catheterization. Comparing the two different routes of MTX administration, it was shown that the resolution time (beta-hCG < 20 mIU/ml) in group B was significantly shorter (2.4 +/- 1.1 weeks vs. 4.1 +/- 1.9 weeks in group A, P < 0.05), with a better success rate (100% and 88%, respectively). Serum MTX levels were found within a low range and no systemic side effects were noticed. In conclusion, direct intraovular MTX injection under ultrasound guidance proved superior to the laparoscopically-controlled 'blind' intratubal injection. A relatively high dose of MTX (100 mg) seems justified in order to shorten the resolution period, especially in cases with high initial beta-hCG levels and/or fetal heart motion present.
Authors:
J Tzafettas; S Anapliotis; V Zournatzi; A Boucklis; N Oxouzoglou; J Bondis
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Early human development     Volume:  39     ISSN:  0378-3782     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1995-04-06     Completed Date:  1995-04-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  101-7     Citation Subset:  IM    
Affiliation:
B University Department of Obstetrics and Gynaecology, Hippokrateio Hospital, Thessaloniki, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amnion / ultrasonography
Chorionic Gonadotropin / blood
Dose-Response Relationship, Drug
Fallopian Tubes / ultrasonography
Female
Humans
Injections / methods
Laparoscopy / methods*,  standards
Methotrexate / administration & dosage*,  adverse effects,  blood
Pregnancy
Pregnancy, Ectopic / blood,  drug therapy*,  physiopathology
Ultrasonography, Prenatal / methods*,  standards
Vagina / ultrasonography
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 59-05-2/Methotrexate

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


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