How to select the cases for the treatment of ectopic pregnancy with a single dose of methotrexate

How to select the cases for the treatment of ectopic pregnancy with a single dose of methotrexate

Author Elito Junior, Julio Autor UNIFESP Google Scholar
Camano, Luiz Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The objective was 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. Our study included 50 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) IM). A predictive score was elaborated based in four parameters: initial levels of beta-hCG, aspects of fue 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. The success rate with a single dose of methotrexate was 80% (40/50). In the present study the cut offgrade was 5, because the majority of patients with grade greater than or equal to 5 were treated successfully (39/40 -97.5%), while those with grade < 5 failed. 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 fue grade is greater than or equal to 5.
Keywords ectopic pregnancy
methotrexate
predictive score
Language Spanish
Date 2001-12-01
Published in Acta Bioquimica Clinica Latinoamericana. La Plata, Buenos Aires: Federacion Bioquimica Provincia Buenos Aires, v. 35, n. 4, p. 545-553, 2001.
ISSN 0325-2957 (Sherpa/Romeo, impact factor)
Publisher Federacion Bioquimica Provincia Buenos Aires
Extent 545-553
Origin Não encontrado
Access rights Closed access
Type Article
Web of Science ID WOS:000173961900014
URI http://repositorio.unifesp.br/11600/41973

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