|
KMID : 0386019960080010042
|
|
Korean Journal of Gynecology Endoscopy and Minimally Invasive Surgery
1996 Volume.8 No. 1 p.42 ~ p.47
|
|
|
The Preventive Effect of Single-Dose Methotrexate for Persistent Ectopic Pregnancy After Laparoscopic Conservative Tratment
|
|
김재훈/Kim, JH
한수/오성택/Han, S/Oh, ST
|
|
|
Abstract
|
|
|
In order to evaluate the effect of postoperative methotrexate (MTX) treatment for prevention of persistent cctopic pregnancy in patients who treated with conservative surgery under laparoscopy, 56 patients,. high risk group among the patients who were diagnosed as unruptured early ectopic pregnancy and treated with conservative method such as salpingotomy with or without suture or fimbrial squeezing under laparoscopy, were studied from December 1992 ; to march 1996. The criteria of high risk group were as follows; gestational sac was not easily evacuated from tube with massive bleeding tendency during operation, gestational sac was larger than 3cm in diameter, in patients treated with fimbrial squeezing, preoperative serum progesterone levels were more than 35nmol / L and more than 100m1U / ml or 40% daily increase of serum ?-hCG, preoperative serum fl-?-CG was greater than 3000mWU / ml.
MTX 1.0mg / kg was injected intramuscularly on first day after operation in 36 of 56 patients after checking CBC with differential count and LFT, and persistent ectopic pregnancy was carefully ckecked by serial -hCG follow up. The other 20 patients were followed up by only serial serum -hCG without any treatment. The incidence of persistent ectopic pregnancy was 10 of 20 patients in untreated control group, but no case of 36 patients in MIX-treated group. This difference was statistically significant (P < 0.01). The side effect of MTX was appeared in only one patient who showed leukopenia for 1 week and recovered spontaneously.
Therefore, the administration of single dose MTX just after conservative laparoscopic surgery was suggested as a effective preventive method for persistent ectopic pregnancy in high risk group without any serious complication.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|