A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal Fluid
Introduction: Extra-uterine pregnancy or Ectopic Pregnancy (EP) is a major health problem for pregnant women, presenting as a potentially life-threatening emergency in the first trimester. There are three major options for the treatment of EP: expectant management, surgical treatment and medical...
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| Format: | Article |
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JCDR Research and Publications Private Limited
2016-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/8376/20363_CE(RA1)_F(T)_PF1(ROAK)_PFA(P)_PF2(PAG).pdf |
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| author | Mehmet Akif Sargin Murat Yassa Bilge Dogan Taymur Ayhan Çelik Sibel Aydın Emrah Orhan Niyazi Tug |
| author_facet | Mehmet Akif Sargin Murat Yassa Bilge Dogan Taymur Ayhan Çelik Sibel Aydın Emrah Orhan Niyazi Tug |
| author_sort | Mehmet Akif Sargin |
| collection | DOAJ |
| description | Introduction: Extra-uterine pregnancy or Ectopic Pregnancy
(EP) is a major health problem for pregnant women, presenting
as a potentially life-threatening emergency in the first trimester.
There are three major options for the treatment of EP: expectant
management, surgical treatment and medical management. The
presence of free intraperitoneal fluid in EP-diagnosed patients
is crucial for treatment planning and evaluation.
Aim: To compare the outcomes of both the expectant management and medical treatment with methotrexate (MTX) in
ectopic pregnancies with free intraperitoneal fluid.
Materials and Methods: This retrospective cohort study included a total of 91 ectopic pregnancies with or without rupture
in which the women had initial free intraperitoneal fluid and
were haemodynamically stable. Serial b-HCG measurements
were used to assess the outcome of expectant management
and medical treatment with MTX. For the statistical analysis,
the SPSS statistical software package, version 22.0 (Chicago,
IL, USA), was used. For the quantitative variables that were
not distributed normally, the Kruskal-Wallis test and the MannWhitney U test were performed for the evaluation of differences
between the groups.
Results: It was observed that the success rate with expectant
management was 81% (initial b HCG concentration 626±443
mIU/mL). With a single dose of MTX, it was 76% (initial b HCG
concentration 2124±1647 mIU/mL) and with a total single or
double dose of MTX, it was 88% (initial b HCG concentration
2252±78 mIU/mL) from among EP with or without rupture in
women with initial free intraperitoneal fluid during diagnosis.
There was no significant difference between the groups with
regard to ultrasonography findings.
Conclusion: Expectant management or medical treatment
with methotrexate should be the first line treatment for ectopic
pregnancies with initial free intraperitoneal fluid, albeit with
rupture, in patients who are haemodynamically stable, along
with b-HCG follow-up. |
| first_indexed | 2024-12-11T00:23:17Z |
| format | Article |
| id | doaj.art-49f1298c9e37455bba4c8911439d28df |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-11T00:23:17Z |
| publishDate | 2016-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-49f1298c9e37455bba4c8911439d28df2022-12-22T01:27:39ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2016-08-01108QC22QC2610.7860/JCDR/2016/20363.8376A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal FluidMehmet Akif Sargin0Murat Yassa1Bilge Dogan Taymur2Ayhan Çelik3Sibel Aydın4Emrah Orhan5Niyazi Tug6Lecturer, Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.Lecturer, Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.Lecturer, Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.Lecturer, Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.Lecturer, Department of Obstetrics and Gynecology, Umraniye Training and Research Hospital, İstanbul, Turkey.Student, Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.Associate Professor, Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.Introduction: Extra-uterine pregnancy or Ectopic Pregnancy (EP) is a major health problem for pregnant women, presenting as a potentially life-threatening emergency in the first trimester. There are three major options for the treatment of EP: expectant management, surgical treatment and medical management. The presence of free intraperitoneal fluid in EP-diagnosed patients is crucial for treatment planning and evaluation. Aim: To compare the outcomes of both the expectant management and medical treatment with methotrexate (MTX) in ectopic pregnancies with free intraperitoneal fluid. Materials and Methods: This retrospective cohort study included a total of 91 ectopic pregnancies with or without rupture in which the women had initial free intraperitoneal fluid and were haemodynamically stable. Serial b-HCG measurements were used to assess the outcome of expectant management and medical treatment with MTX. For the statistical analysis, the SPSS statistical software package, version 22.0 (Chicago, IL, USA), was used. For the quantitative variables that were not distributed normally, the Kruskal-Wallis test and the MannWhitney U test were performed for the evaluation of differences between the groups. Results: It was observed that the success rate with expectant management was 81% (initial b HCG concentration 626±443 mIU/mL). With a single dose of MTX, it was 76% (initial b HCG concentration 2124±1647 mIU/mL) and with a total single or double dose of MTX, it was 88% (initial b HCG concentration 2252±78 mIU/mL) from among EP with or without rupture in women with initial free intraperitoneal fluid during diagnosis. There was no significant difference between the groups with regard to ultrasonography findings. Conclusion: Expectant management or medical treatment with methotrexate should be the first line treatment for ectopic pregnancies with initial free intraperitoneal fluid, albeit with rupture, in patients who are haemodynamically stable, along with b-HCG follow-up.https://jcdr.net/articles/PDF/8376/20363_CE(RA1)_F(T)_PF1(ROAK)_PFA(P)_PF2(PAG).pdfchorionic gonadotropinhaemoperitoneummethotrexate |
| spellingShingle | Mehmet Akif Sargin Murat Yassa Bilge Dogan Taymur Ayhan Çelik Sibel Aydın Emrah Orhan Niyazi Tug A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal Fluid Journal of Clinical and Diagnostic Research chorionic gonadotropin haemoperitoneum methotrexate |
| title | A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal Fluid |
| title_full | A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal Fluid |
| title_fullStr | A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal Fluid |
| title_full_unstemmed | A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal Fluid |
| title_short | A Clinical Experience of Ectopic Pregnancies with Initial Free Intraperitoneal Fluid |
| title_sort | clinical experience of ectopic pregnancies with initial free intraperitoneal fluid |
| topic | chorionic gonadotropin haemoperitoneum methotrexate |
| url | https://jcdr.net/articles/PDF/8376/20363_CE(RA1)_F(T)_PF1(ROAK)_PFA(P)_PF2(PAG).pdf |
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