Document Detail


Is it necessary to operate on all women with an acute abdomen following medical treatment of tubal ectopic pregnancy?
MedLine Citation:
PMID:  20604655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The main objective of this retrospective study is to evaluate the question of whether it is necessary to perform surgery for patients who develop an acute abdomen after methotrexate administration in cases of tubal ectopic pregnancy. A total of 26 women with tubal ectopic pregnancy who required emergency surgical evaluation after a single dose of methotrexate treatment were included. The surgical findings were tubal abortion (10 cases, 38.4%); tubal rupture (12 cases, 46.2%) and tubal haematoma (4 cases, 15.4%). The average time for initiation of severe abdominal pain following single dose methotrexate treatment was 6.12 +/- 2.10 days (range, 2-10). The most common site of implantation was isthmus (50.0%) and 38.5% (five patients) of the patients had tubal abortion from this part of the tube, while 46.1% of women (six patients) with isthmic localisation had a tubal rupture. Following medical treatment of ectopic pregnancy, surgery may be an option in the presence of symptoms/signs of acute abdomen (in the presence or absence of haemodynamic instability) and free pelvic fluid on sonography for only patients with isthmic tubal ectopic pregnancy, or if the isthmic localisation of tubal ectopic pregnancy is suspected on sonography.
Authors:
S Dilbaz; E S Guvendag Guven; B Aykan Yildirim; O Gelisen; D Karcaaltincaba; V Kurtaran; A Haberal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology     Volume:  30     ISSN:  1364-6893     ISO Abbreviation:  J Obstet Gynaecol     Publication Date:  2010  
Date Detail:
Created Date:  2010-07-07     Completed Date:  2010-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309140     Medline TA:  J Obstet Gynaecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  496-500     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Womens' Health and Teaching Hospital, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Abdomen, Acute / surgery*
Abortifacient Agents, Nonsteroidal / administration & dosage*
Adult
Combined Modality Therapy
Female
Humans
Methotrexate / administration & dosage*
Pregnancy
Pregnancy, Tubal / drug therapy*,  surgery*
Retrospective Studies
Rupture, Spontaneous
Young Adult
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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