Fertility and sterility · 2011
A cohort study to evaluate the effectiveness of laparoscopic-guided local injection of etoposide in the management of women with unruptured tubal pregnancy.
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Chen Ching-Hui, Lee Wen-Ling, Chiu Li-Hsuan, Sun Hsu-Dong, Liu Wei-Min, Wang Peng-Hui
Аннотация
OBJECTIVE: To assess the feasibility of laparoscopic-guided local injection of etoposide or methotrexate (MTX) in the management of unruptured tubal pregnancy and compare the effectiveness of the two regimens.
DESIGN: Retrospective cohort study.
SETTING: Medical center.
PATIENT(S): Thirty-one women with laparoscopically diagnosed unruptured tubal pregnancy.
INTERVENTION(S): A regimen of etoposide 50 mg via laparoscopic-guided local injection (n = 17) compared with a conventional MTX 50 mg regimen (n = 11), after 3 patients were excluded (2 refusals and 1 with salpingostomy).
MAIN OUTCOME MEASURE(S): Serial serum β-hCG levels and the success rate in both groups.
RESULT(S): General characteristics of the patients were similar in both groups. The overall success rate was 96.4% (27 of 28). The duration between treatment and nadir of serum β-hCG level (<5 mIU/mL) was significantly shorter in the etoposide group than in the MTX group (19.7 ± 13.0 days vs. 33.4 ± 8.1 days). No patient in the etoposide group and only 1 in the MTX group needed reintervention, which led to 100% and 91% success rates for the etoposide and MTX groups, respectively. Three women in the etoposide group had subsequently successful term deliveries.
CONCLUSION(S): Both regimens-etoposide 50 mg and MTX 50 mg via laparoscopic-guided local injection-were acceptable in the management of women with unruptured tubal pregnancy because of their similar and high success rates. More studies are needed to confirm this observation.
DESIGN: Retrospective cohort study.
SETTING: Medical center.
PATIENT(S): Thirty-one women with laparoscopically diagnosed unruptured tubal pregnancy.
INTERVENTION(S): A regimen of etoposide 50 mg via laparoscopic-guided local injection (n = 17) compared with a conventional MTX 50 mg regimen (n = 11), after 3 patients were excluded (2 refusals and 1 with salpingostomy).
MAIN OUTCOME MEASURE(S): Serial serum β-hCG levels and the success rate in both groups.
RESULT(S): General characteristics of the patients were similar in both groups. The overall success rate was 96.4% (27 of 28). The duration between treatment and nadir of serum β-hCG level (<5 mIU/mL) was significantly shorter in the etoposide group than in the MTX group (19.7 ± 13.0 days vs. 33.4 ± 8.1 days). No patient in the etoposide group and only 1 in the MTX group needed reintervention, which led to 100% and 91% success rates for the etoposide and MTX groups, respectively. Three women in the etoposide group had subsequently successful term deliveries.
CONCLUSION(S): Both regimens-etoposide 50 mg and MTX 50 mg via laparoscopic-guided local injection-were acceptable in the management of women with unruptured tubal pregnancy because of their similar and high success rates. More studies are needed to confirm this observation.