Gynecologie, obstetrique & fertilite · 2013
[Prognostic value of early hCG changes after methotrexate injection for ectopic pregnancy].
Аннотация на английскомСтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Bottin P, Gnisci A, Crochet P, Butzbach P, Cravello L, Gamerre M, Agostini A
Аннотация
OBJECTIVES: The purpose of this study was to evaluate the predictive value of early hCG changes on the risk of methotrexate (MTX) therapy failure for ectopic pregnancy.
PATIENTS AND METHODS: This monocentric observational study compared the success of single-dose MTX therapy according to early hCG changes. Patients with a decrease of hCG value by at least 20% between day 1 and day 4 were followed up one month later only with an hCG concentration (group A, study protocol). The others patients were followed up with classic protocol, one time a week (group B).
RESULTS: Of the 91 patients treated, there were 29 (31.9%) patients in the group A and 62 (68.1%) in the group B. The overall success rate of MTX treatment was 89%. The success rate of single-dose MTX therapy was significantly increased in group A (29/29 (100%) vs 30/62 (48.4%), P<0.001). The rate of patients requiring surgical treatment was significantly lower in group A (0/29 vs 10/62 (16%), P=0.02) (Table 1).
CONCLUSION: The 20%-decrease cut-off between day 1 and day 4 appears to be a predictive factor to select patients with low failure rate after one MTX injection, allowing a less stringent follow-up.
PATIENTS AND METHODS: This monocentric observational study compared the success of single-dose MTX therapy according to early hCG changes. Patients with a decrease of hCG value by at least 20% between day 1 and day 4 were followed up one month later only with an hCG concentration (group A, study protocol). The others patients were followed up with classic protocol, one time a week (group B).
RESULTS: Of the 91 patients treated, there were 29 (31.9%) patients in the group A and 62 (68.1%) in the group B. The overall success rate of MTX treatment was 89%. The success rate of single-dose MTX therapy was significantly increased in group A (29/29 (100%) vs 30/62 (48.4%), P<0.001). The rate of patients requiring surgical treatment was significantly lower in group A (0/29 vs 10/62 (16%), P=0.02) (Table 1).
CONCLUSION: The 20%-decrease cut-off between day 1 and day 4 appears to be a predictive factor to select patients with low failure rate after one MTX injection, allowing a less stringent follow-up.