Elito Junior Julio, Han Kyung Koo, Camano Luiz
Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Maria Carolina 68, Jardim Paulistano, São Paulo (SP), CEP 01445-000, Brazil.
Sao Paulo Med J. 2006 Sep 7;124(5):264-6. doi: 10.1590/s1516-31802006000500005.
As there is little information about fertility outcomes among women following clinical treatment (methotrexate and expectant management) and surgery (salpingectomy) consequent to ectopic pregnancy, we evaluate the results from hysterosalpingography subsequent to treatment. The objective was to evaluate contralateral tubal patency using hysterosalpingography following surgery and clinical treatment of tubal pregnancy.
This was a prospective study at the Department of Obstetrics of Universidade Federal de São Paulo, a tertiary center.
Among 115 patients who underwent hysterosalpingography following surgery and clinical treatment of tubal pregnancy between April 1994 and February 2002, 30 were treated with a single intramuscular dose of methotrexate (50 mg/m(2)), 50 were followed up expectantly and 35 underwent salpingectomy.
The patency of the ipsilateral tube was 84% after methotrexate treatment and 78% after expectant management. In addition, contralateral tubal patency was 97% after methotrexate treatment, 92% after expectant management and 83% after salpingectomy. There were no statistically significant differences between the clinical treatment and surgery groups.
The findings from this study suggest similar contralateral tubal patency rates following salpingectomy, methotrexate treatment and expectant management.
由于关于异位妊娠临床治疗（甲氨蝶呤及期待治疗）和手术（输卵管切除术）后女性生育结局的信息较少，我们评估了治疗后子宫输卵管造影的结果。目的是通过子宫输卵管造影评估输卵管妊娠手术和临床治疗后对侧输卵管的通畅情况。
这是一项在圣保罗联邦大学妇产科进行的前瞻性研究，该科室为三级医疗中心。
在1994年4月至2002年2月期间接受输卵管妊娠手术和临床治疗后进行子宫输卵管造影的115例患者中，30例接受单次肌内注射甲氨蝶呤（50 mg/m²）治疗，50例进行期待随访，35例行输卵管切除术。
甲氨蝶呤治疗后同侧输卵管通畅率为84%，期待治疗后为78%。此外，甲氨蝶呤治疗后对侧输卵管通畅率为97%，期待治疗后为92%，输卵管切除术后为83%。临床治疗组和手术组之间无统计学显著差异。
本研究结果表明，输卵管切除术、甲氨蝶呤治疗和期待治疗后对侧输卵管通畅率相似。
