[Comparison on efficacy between the different timings of methotrexate administration combined with laproscopy in the treatment of salpingocyesis].

OBJECTIVES

To compare pretreatment and intra-operative methotrexate (MTX) administration when combined with laproscopy in the treatment of salpingocyesis.

METHODS

All 200 patients with salpingocyesis treated with laproscopy in Jiangwan Hospital from Jan, 2010 to Dec, 2014 were enrolled and divided into group A and B, 100 patients in each. In group A, the patients were administered with MTX 50 mg/kg by intramuscular injection 24-48 h before the surgery. In group B, the patients were administered with MTX 20 mg in 2 ml normal saline to the target tubal seromuscular layer after the ectopic pregnancies were removed. Then, the following characteristics would be compared between the groups including the medical condition during the operation, post-operative body temperature, serum β-human chorionic gonadotropin (β-HCG) reduction, the rate of refractory ectopic pregnancy and tubal patency.

RESULTS

The bleeding volume during the surgery (P<0.01) was significantly reduced and the operation duration (P<0.05) was significantly shortened in group A. The serum β-HCG level (P<0.05) was also significantly reduced 4 and 7 days after the surgery in group A. There was significantly difference on the rate of tubal patency (P<0.01) between the groups. There was no refractory ectopic pregnancy in either groups after the surgery. And there were no significant differences on the post-operative temperature, period of serum β-HCG moving to the normal level between the groups (P>0.05).

CONCLUSIONS

Both pretreatment and intra-operative MTX administration showed good efficacy. But the surgery duration shortening, bleeding decreasing during the operation and tubes retaining were seen in group A. For this reason, we believe pro-operative MTX administration would be better for the patients with childbearing requests.