经阴道输卵管内注射甲氨蝶呤治疗异位妊娠。

Transvaginal intratubal methotrexate treatment of ectopic pregnancy.

作者信息

Tulandi T, Atri M, Bret P, Falcone T, Khalife S

机构信息

Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.

出版信息

Fertil Steril. 1992 Jul;58(1):98-100. doi: 10.1016/s0015-0282(16)55143-7.

DOI:10.1016/s0015-0282(16)55143-7

PMID:1624030

Abstract

OBJECTIVE

To evaluate the efficacy of transvaginal intratubal methotrexate (MTX) treatment of tubal ectopic pregnancy (EP).

SETTING

Outpatient setting in University Hospital.

PATIENTS

Forty women with early EP and rising serum beta-human chorionic gonadotropin (beta-hCG) levels.

INTERVENTION

Transvaginal intratubal administration of MTX (1 mg/kg body weight).

MAIN OUTCOME MEASURES

Success was defined as declining serum beta-hCG to undetectable levels, no tubal dilatation on ultrasound examination, and no further intervention was required.

RESULTS

Treatment was associated with a 70% success rate. No difference was found in the success rate between women with an embryo (76.9%) and those with no embryo in their fallopian tubes (66.7%). The initial serum beta-hCG levels were also not different between patients who were successfully treated and those who failed to respond to the treatment. Despite declining serum beta-hCG levels, tubal rupture occurred in two patients.

CONCLUSIONS

Treatment of EP by transvaginal MTX administration is associated with a 70% success rate. This is independent of the presence of an embryo or the initial serum beta-hCG levels. Rupture of EP can still occur despite low and declining serum beta-hCG levels.

摘要