Fertility and sterility · 2004
Characterizing ectopic pregnancies that rupture despite treatment with methotrexate.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dudley Paul S, Heard Michael J, Sangi-Haghpeykar Haleh, Carson Sandra A, Buster John E
Аннотация
OBJECTIVE: To identify risk factors for tubal rupture among ectopic pregnancies treated with methotrexate (MTX).
DESIGN: Retrospective case-control analysis.
SETTING: An urban medical center.
PATIENT(S): Eighty-one women diagnosed with an ectopic gestation treated with MTX: 19 patients experienced subsequent tubal rupture, and 62 patients experienced ectopic resolution.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Predictive variables including serial human chorionic gonadotropin (hCG) values.
RESULT(S): The hCG incremental rate before as well as after MTX administration was positively associated with tubal rupture. HCG values prior to ectopic diagnosis that increased at least 66% over 48 hours and rising hCG values after treatment with methotrexate were independent predictors of tubal rupture. A disproportionate number (47%) of ectopic pregnancies that ruptured were located in the tubal isthmus.
CONCLUSION(S): The hCG incremental rate both before and after MTX represents an independent risk factor for subsequent tubal rupture. Concentrations of hCG before ectopic diagnosis that increased at least 66% over 48 hours, or persistently rising hCG concentrations after treatment with MTX, may lower the threshold for surgical intervention. Implantation site may represent an unidentifiable risk factor for tubal rupture.
DESIGN: Retrospective case-control analysis.
SETTING: An urban medical center.
PATIENT(S): Eighty-one women diagnosed with an ectopic gestation treated with MTX: 19 patients experienced subsequent tubal rupture, and 62 patients experienced ectopic resolution.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Predictive variables including serial human chorionic gonadotropin (hCG) values.
RESULT(S): The hCG incremental rate before as well as after MTX administration was positively associated with tubal rupture. HCG values prior to ectopic diagnosis that increased at least 66% over 48 hours and rising hCG values after treatment with methotrexate were independent predictors of tubal rupture. A disproportionate number (47%) of ectopic pregnancies that ruptured were located in the tubal isthmus.
CONCLUSION(S): The hCG incremental rate both before and after MTX represents an independent risk factor for subsequent tubal rupture. Concentrations of hCG before ectopic diagnosis that increased at least 66% over 48 hours, or persistently rising hCG concentrations after treatment with MTX, may lower the threshold for surgical intervention. Implantation site may represent an unidentifiable risk factor for tubal rupture.