Ektopik gebelik tedavisinde metotreksat kullanımı: Tedavi sonucunu etkileyen faktörler

Cilt: 52 Sayı: 4 1 Aralık 2013
  • Uğurlucan F G
  • İyibozkurt A C
  • Çetin C
  • Nehir A
  • Akhan S
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Methotrexate treatment for ectopic pregnancy: Factors affecting treatment outcome

Abstract

Objective: To evaluate factors affecting treatment outcome of patients receiving methotrexate for treatment of ectopic pregnancy. Materials and Methods: Patients who were hospitalized for ectopic pregnancy and received methotrexate from 2005 onwards, were analyzed. Demographic variables, β-hCG values, transvaginal-ultrasonography findings, factors affecting treatment outcome were analyzed. Results: Data of 83 patients were analyzed. Treatment was successful in 65 (78.3%), failed in 18 patients (21.7%), and rupture occurred in 6 of these (7.2%). The mean age was 30.4±5.4. The main presenting symptoms were vaginal bleeding (n=47; 56.6%) and abdominal pain (n= 36; 43.4%). Sonographic findings were extrauterine masses in 66 (79.5%), gestational sac in 9 (10.8%), fetal cardiac activity in 5(6%), and free fluid in the Douglas space in 4 patients (4.8%). The mean diameter of the ectopic mass in treatment success and treatment failure groups was 2.5±1.1cm and 3.0±1.9cm, respectively. The difference was not statistically significant. As the size of the extrauterine mass increased above 30 mm, the failure rate increased. The mean β-hCG on the day of methotrexate in treatment success and treatment failure groups was 2915±3079 mIU/ml and 4519±3834mIU/ml, respectively, which was statistically significant. The failure rate increased as B-hCG increased above 2000 mIU/ml. The mean β-hCG on the day of methotrexate in cases resulting in rupture was 5936±2676 mIU/ml. The difference was not statistically significant. One patient suffered from hepatotoxicity, one from diarrhea, one from mucositis, and one from tinnitus during treatment. Conclusion: Methotrexate is safe for treatment of ectopic pregnancy. Baseline β-hCG and size of the extrauterine mass affect treatment success. As B-hCG increased above 2000 mIU/ml and the size of the extrauterine mass increased above 30 mm, the failure rate increased.

Keywords

Ayrıntılar

Birincil Dil

Türkçe

Konular

-

Bölüm

-

Yazarlar

Uğurlucan F G

İyibozkurt A C

Çetin C

Nehir A

Akhan S

Yayımlanma Tarihi

1 Aralık 2013

Gönderilme Tarihi

1 Aralık 2013

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2013 Cilt: 52 Sayı: 4

IZ

https://izlik.org/JA52DB45BH

Kaynak Göster

RIS / Bibtex
Vancouver
1.Uğurlucan F G, İyibozkurt A C, Çetin C, Nehir A, Akhan S. Ektopik gebelik tedavisinde metotreksat kullanımı: Tedavi sonucunu etkileyen faktörler. ETD [Internet]. 01 Aralık 2013;52(4):199-204. Erişim adresi: https://izlik.org/JA52DB45BH

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