Predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate

Predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate

Autor Elito Junior, Julio Autor UNIFESP Google Scholar
Reichmann, A. P. Google Scholar
Nakamura, Mary Uchiyama Autor UNIFESP Google Scholar
Camano, Luiz Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Objective: To evaluate the efficacy of a predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate in order to select the best cases for the medical treatment. Method: Our study included 40 patients. the inclusion criteria were: hemodynamic stability; adnexal mass less than or equal to 3.5 cm; desire of future pregnancy; and a written permission to participate in the study. All patients were treated with a single dose of methotrexate (50 mg/m(2) i.m.). A predictive score was elaborated based on four parameters: initial levels of beta-hCG, aspects of the image at ultrasound (hematosalpinx, tubal ring or live embryo), size of the mass, vascular flow of the color Doppler. Each parameter received a grade from 0 to 2. Grade 0 represented an unfavorable situation, grade 1 a borderline situation and grade 2 a favorable situation. Results: the success rate with a single dose of methotrexate was 75% (30/40). in the present study the cut off grade was 5, because the majority of patients with grade 2 5 were treated successfully (29/30 - 97%), while those with grade < 5 failed. Conclusion: the predictive score helps us to indicate the best cases for the medical treatment. Therefore, we do not advise it when the grade is < 5. However, we can predict a good evolution of the treatment when the grade is greater than or equal to 5. (C) 1999 International Federation of Gynecology and Obstetrics.
Palavra-chave ectopic pregnancy
predictive score
methotrexate
single dose
medical treatment
Idioma Inglês
Data de publicação 1999-11-01
Publicado em International Journal of Gynecology & Obstetrics. Clare: Elsevier Sci Ireland Ltd, v. 67, n. 2, p. 75-79, 1999.
ISSN 0020-7292 (Sherpa/Romeo, fator de impacto)
Publicador Elsevier B.V.
Extensão 75-79
Fonte http://dx.doi.org/10.1016/S0020-7292(99)00114-9
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000083712900002
Endereço permanente http://repositorio.unifesp.br/handle/11600/26167

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