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Efficacy of In Situ Methotrexate Injection in the Treatment of Nontubal Ectopic Pregnancies: A Retrospective Multicenter Study.
Herondelle, Charlyne; Spiers, Andrew; Nyangoh-Timoh, Krystel; Thubert, Thibault; Fauconnier, Arnaud; Moquet, Pierre-Yves; Bouet, Pierre-Emmanuel; Legendre, Guillaume.
Afiliación
  • Herondelle C; Department of Obstetrics and Gynecology, Angers University Hospital (Drs. Herondelle, Bouet, and Legendre and Mr. Spiers), Angers; Department of Obstetrics and Gynecology, Nantes University Hospital (Drs. Herondelle and Thubert), Nantes.
  • Spiers A; Department of Obstetrics and Gynecology, Angers University Hospital (Drs. Herondelle, Bouet, and Legendre and Mr. Spiers), Angers.
  • Nyangoh-Timoh K; Department of Obstetrics and Gynecology, Rennes University Hospital (Dr. Nyangoh-Timoh).
  • Thubert T; Department of Obstetrics and Gynecology, Nantes University Hospital (Drs. Herondelle and Thubert), Nantes.
  • Fauconnier A; Department of Obstetrics and Gynecology, Intercommunal Hospital of Poissy/Saint-Germain-en-Laye (Dr. Fauconnier), Poissy.
  • Moquet PY; Department of Obstetrics and Gynecology, La Sagesse Clinic (Dr. Moquet), Rennes.
  • Bouet PE; Department of Obstetrics and Gynecology, Angers University Hospital (Drs. Herondelle, Bouet, and Legendre and Mr. Spiers), Angers.
  • Legendre G; Department of Obstetrics and Gynecology, Angers University Hospital (Drs. Herondelle, Bouet, and Legendre and Mr. Spiers), Angers; CESP UMR Inserm 1018 - Center for Research in Epidemiology and Public Health (Dr. Legendre), Villejuif, France. Electronic address: guillaume.legendre@chu-angers.fr.
J Minim Invasive Gynecol ; 29(2): 243-249, 2022 02.
Article en En | MEDLINE | ID: mdl-34400353
STUDY OBJECTIVE: Evaluation of the efficacy of different injection sites of methotrexate in the treatment of nontubal ectopic pregnancies. DESIGN: Retrospective multicenter study. SETTING: Multicenter, including 3 teaching hospitals, an intercommunal hospital, and a clinic. PATIENTS: A total of 106 patients with nontubal ectopic pregnancies, including 59 interstitial, 39 cesarean scar, and 8 cervical or isthmic. INTERVENTIONS: Overall, 58 patients received methotrexate via intramuscular injection (IM group), 35 received methotrexate via in situ injection (IS group), and 13 received a combination of both in situ and intramuscular injections of methotrexate (IS + IM group). MEASUREMENTS AND MAIN RESULTS: The main end point of this study was measured via the primary success rate (defined as a negative ß-human chorionic gonadotropin level without recourse to any additional treatment) of treatment with methotrexate according to injection site. The primary success rate was 46.55% in the IM group, 60% in the IS group, and 61.54% in the IS + IM group, respectively. In the multivariate analysis, the primary success rate of treatment was significantly correlated to the in situ injection of methotrexate, either solely or in conjunction with an intramuscular injection of methotrexate administered the following day, (odds ratio = 2.7; 95% confidence interval, 1.03-7.14). CONCLUSION: Solely an intramuscular injection of methotrexate is a less efficient first-line treatment strategy for the conservative management of nontubular ectopic pregnancy. The use of an in situ injection of methotrexate should therefore be preferred.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embarazo Ectópico / Abortivos no Esteroideos Tipo de estudio: Observational_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: J Minim Invasive Gynecol Asunto de la revista: GINECOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embarazo Ectópico / Abortivos no Esteroideos Tipo de estudio: Observational_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: J Minim Invasive Gynecol Asunto de la revista: GINECOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos