Single dose Methotrexate injection, could be a safe and effective treatment for early cases of tubal ectopic pregnancy, with minimal maternal health hazards | ||
| Evidence Based Women's Health Journal | ||
| Article 5, Volume 9, Issue 3, August 2019, Pages 501-506 PDF (330.97 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ebwhj.2019.45495 | ||
| Author | ||
| Hossam H. Soliman,* | ||
| Department of Obstetrics and Gynecology, Al Galaa Maternity Meaching Hospital, Cairo | ||
| Abstract | ||
| first method is described as a conservative medical method in which we use a chemotherapeutic agent (Methotrexate) to eradicate the ectopic tubal conception, whereas the second method implies a conservative laparoscopic surgery in which overwhelming efforts are done in order to maintain a tube affected by ectopic pregnancy as healthy as possible following removal of the ectopic pregnancy mass. The fallopian tubes are assessed for patency and tubal lumen contour and pattern 3 months following successful treatment, in order to detect which method would lead to a high cure rate with the least tubal detrimental effect. Patients and Methods: In the current study, 58 patients diagnosed with tubal ectopic pregnancy were given Methotrexate as a first choice chemotherapeutic agent aiming to resolve the ectopic pregnancy, whereas 58 patients with the same condition gone directly through laparoscopic salpingostomy, with the aim of maintaining patent healthy tube finally after successful treatment. Results: The study revealed no significant difference for either treatment modalities in affecting the rate of bilateral tubal obstruction, or tubal patency with a recognized tubal defect with a p >0.05. On the other hand, cases with unilateral tubal obstruction involving the affected tube were remarkably increased in the methotrexate group (13 cases) out of 52 cases with successful treatment compared to 6 cases successfully treated by salpingostomy (6 cases) out of 52 cases successfully treated, with a p<0.05 . Conclusion: In conclusion, single dose methotrexate has proven to be a safe, effective and reasonably convenient treatment for most patients, shown during counseling to be so worry about surgery and its potential detrimental consequences on their future fertility. Yet, it should be obviously highlighted that such concepts and perspectives for keeping fertility can’t be taken as for granted and a guarantee for a healthy patent tube as it is quite obvious that even with successful elimination of the chorionic tissue in the tube, the affected tube might still be blocked and with a significant rate further exceeding the excepted rate with laparoscopic salpingostomy. | ||
| Keywords | ||
| Tubal ectopic pregnancy; Methotrexate; laparoscopic salpingostomy; hysterosalpingography; tubal patency | ||
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