A retrospective review of uterine scar pregnancies: single centre experience
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Medical record
Uterine rupture
Abstract Three cases of cesarean scar pregnancy successfully treated with methotrexate are described. The diagnosis was confirmed by transvaginal sonographic examinations showing a well‐formed gestational sac in the myometrium of the lower uterine segment. Initial treatment with a systemic injection of 50 mg of methotrexate was not sufficient, and multiple doses were required to obtain a complete remission in two cases. In a case with a β‐hCG level of more than 20,000 mIU/mL with a viable embryo in a gestational sac, a combination of systemic and local treatment with methotrexate was required. It took 7–11 weeks for the β‐hCG level to become undetectable and 12–17 weeks for the cesarean scar pregnancy mass to disappear completely.
Myometrium
Antifolate
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Objective:To investigate the curative effect of sequential treatments with methotrexate and mifepristone for ectopic pregnancy.Methods:132 cases in our hospital from November 2001 to May 2003 were diagnosed ectopic pregnancy.Methotrexate was given as standard as 40 mg/m2 i.m and mifepristone was taken orally 12 hours later and the sequential treatments were repeated not more than 4 times each 5 days.Serum β-HCG level was detected by immunofluorescence.Results:The serum β-HCG level of most of the cases descended by different levels.119 cases of the 132 cases reached the level of recovery.The recovered rate was 90.1%.Conclusion:The sequential therapy with methotrexate and mifepristone is an effective method for the treatment to ectopic pregnancy.
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Objective To investigate the curative effect of sequential treatments with methotrexate and mifepristione for ectopic pregnancy.Methods Thirty three cases in our hospital from November 2001 to May 2003 were diagnosed ectopic pregnancy.Methotrexate was given as standard as 40mg/m 2 i.m. and mifepristone was taken orally 12 hours later and the sequential treatments were repeated not more than 4 times each 5 days.Serum β HCG level was detected by immunofluorescence.Results Thirty cases recovered completely through the sequential treatments and the serum β HCG level was decreased in all patients.The total recovering rate was nearly 100%.Conclusion The sequential therapy with methortexate and mifepristone is an effective method for the treatment to ectopic pregnancy.
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Injection Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location – An Audit of Cases at Princess Alexandra Hospital, UK Ectopic pregnancy is usually treated with surgery. Injection methotrexate is a treatment option for ectopic pregnancy and for Pregnancy of Unknown Location. Meta-analysis of studies have not shown a statistical difference in the success rate or future pregnancy rate or recurrent ectopic pregnancy rate when comparing injection methotrexate with surgery.
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Objective: To evaluate the efficacy and safety of methotrexate(MTX) injection for ectopic pregnancy under ultrasound-guidance.Methods: 30 patients with ectopic pregnancy were treated with MTX injection under ultrasound-guidance followed by administration of mifepristone for 3 days(25mg,bid).Serum level of β-hCG was tested before treatment and then once a week after MTX injection.Results: 2-12weeks after MTX injection,β-hCG turned to be negative in 29 patients(96.7%).1 patient(3.3%) received operation because of the rupture lesion.Conclusion: Within considerable indication,MTX injection under ultrasound-guidance is effective and safe for patients with ectopic pregnancy.
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Objective To investigate the efficacy of mifepristone and methotrexate for ectopic pregnancy. Methods 102 cases of unrupture of ectopic pregnancy were randomly divided into A and B groups. Group A with 52 cases was treated with mifepristone and methotrexate; Group B with 50 cases was treated with methotrexate. Results The success rate of group A was 90.38%, which was significantly higher than that of group B. Conclusion Mifepristone and methotrexate have many advantages for ectopic pregnancy such as safety, good effect, easily performed and less medical cost. So it is worth applying in the clinic.
Group B
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Objective To explore the effect of treating ectopic pregnancy by methotrexate combined with mifepristone.Methods 92 patients with ectopic pregnancy were randomly divided into a control group and the observation group.The control group of 45 patients were given methotrexate,and the observation group of 47 patients were given methotrexate combined with mifepristone.After the end of treatment,two groups were evaluated in the total efficiency,the time of β-HCG close to normal and adverse reactions.Results After treatment and compared with the control group,the total efficiency and the time of β-HCG close to normal of the observation group were significantly improved(P0.05),the incidence of adverse reactions was no difference(P 0.05).Conclusion The effect of treating ectopic pregnancy by methotrexate combined with mifepristone is safe and effective,and it is a better method for clinical conservative treatment of ectopic pregnancy.
Conservative Treatment
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Objective To explore the clinical efficacy of mifepristone combined with methotrexate in the treatment of ectopic pregnancy.Methods The data of patients with ectopic pregnancy were analyzed retrospectively.60 cases treated with methotrexate were set as a control group,and 60 cases treated with mifepristone combined with methotrexate as a treatment group.The β-HCG values,the size of mass,the hospital stays,and therapeutic efficacies were compared between the two groups after the therapy.Results The β-HCG values of the treatment group and the control group were (768.5 ± 79.3) mIU/mL and (918.0 ± 82.3) mIU/mL,respectively.The mass of the treatment group and the control group were (1.4 ± 0.8) cm and (2.8 ± 1.3) cm,respectively.The hospital stays of the treatmnent group and the control group were (8.3 ± 5.9) d and (13.1 ± 7.8) d,respectively.The β-HCG value,the size of mass,and the hospital stays of the treatment group are greatly lower than those of the control group,with statistical differences (P ＜ 0.05).The therapeutic efficiency of the treatment group and the control group were 93.3％ and 75.0％,respectively.The therapeutic efficiency of the treatment group was significantly higher than that of the control group.Conclusions Mifepristone combined with methotrexate in the treatment of ectopic pregnancy can be popularized in clinic,which has higher therapeutic efficiency than methotrexate alone.
Key words:
Ectopic pregnancy; Mifepristone; Methotrexate; Clinical efficacy
Therapeutic effect
Clinical efficacy
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Objective To observe the efficacy of the combined medication of mifepristone,methotrexate and gongwaiyun No. 2 in the patients of ectopic pregnancy with different serum β- h CG values. Methods Eighty patients of ectopic pregnancy were selected randomly from May 2013 to May 2015. All of patients were layered based on blood β- h CG values and divided into two groups according to therapeutic methods,40 cases in each one. In the control group,the combined medication of methotrexate and gongwaiyun No.2 was prescribed. In the research group,the combined medication of mifepristone,methotrexate and gongwaiyun No. 2 was prescribed. Results For the patients with β- h CG value 1000 to 2000 U / L,the curative rate in the research group was higher significantly than that in the control group( P 0. 05). The time of the relief of abdominal pain and masses as well as the time of β- h CG negative were shorter than those in the control group( P 0. 05). Conclusion The combined medication of mifepristone,methotrexate and gongwaiyun No. 2 achieves the better efficacy on ectopic pregnancy in the patients with β- h CG value 1000 to2000 U / L.
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Objective:To compare efficacy of ectopic pregnancy patients treated with single-dose or multidose methotrexate(MTX)protocols.Methods:The age of patient,gestational age,serum human chorionic gonadotropin,overall ectopic mass size,history of ectopic pregnancy,number of treatment days in hospital,and outcome in consecutive patients with ectopic pregnancy treated with methotrexate were compared.Results:Successful rates were 86.11% and 87.5% respectively,there were no significantly differences.Conclusion:Single-dose methotrexate protocols is as effective as multidose methotrexate protocols,but the former is more convenient than the latter.
Human chorionic gonadotropin
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