COMBINED CHEMOTHERAPY IN THE MEDICAL-MANAGEMENT OF TUBAL PREGNANCY

被引：4

作者：

ANANDAKUMAR, C ^{[1
]}

CHOOLANI, MA ^{[1
]}

ADAIKAN, PG ^{[1
]}

WONG, YC ^{[1
]}

GOPAL, M ^{[1
]}

MARSHALL, B ^{[1
]}

RATNAM, SS ^{[1
]}

机构：

[1] NATL UNIV SINGAPORE HOSP, DEPT OBSTET & GYNAECOL, SINGAPORE 0511, SINGAPORE

来源：

AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY | 1995年 / 35卷 / 04期

关键词：

D O I：

10.1111/j.1479-828X.1995.tb02162.x

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

The medical management of early unruptured tubal ectopic pregnancies is gaining acceptance internationally as an alternative to surgical procedures; This method has been shown to be effective and safe in properly selected cases and with adequate supervision. Most of the work however has been done using tither methotrexate or prostaglandins. The present study aimed to evaluate the efficacy of a combined therapeutic regimen. The efficacy was noted to be at least as good but with fewer side-effects. The treatment was effective in 18 out of 19 cases of tubal pregnancies (94.7%). One patient complained of a gastritis which resolved with antacids. One patient experienced abdominal cramps and transient hypotension probably as a profound vagal response during tubal abortion. The median time to resolution varied directly with the initial serum beta HCC level at diagnosis. All patients who responded to the therapy described the experience as painless and viewed the treatment positively as it spared them the need for surgery and its attendant anaesthetic risks. However, we strongly recommend caution and close supervision and to keep the patient in the hospital at least for the first week of therapy.

引用

页码：437 / 440

页数：4

共 15 条

[1]

Stabile I, Grudzinskas JG., Ectopic pregnancy: A Review of Incidence, Etiology and Diagnostic Aspects, Obstet Gynecol Surv, 45, pp. 335-347, (1990)

[2]

Toumivaara L, Kauppila A, Puolakka J., Ectopic pregnancy: An analysis of the etiology, diagnosis and treatment in 552 cases, Archives of Gynecology, 237, pp. 135-147, (1986)

[3]

Pansky M, Golan A, Bukovsky I, Caspi E., Nonsurgical management of tubal pregnancy, Am J Obstet Gynecol, 164, pp. 888-895, (1991)

[4]

Stovall TG, Ling FW, Gray LA, Carson SA, Buster JE., Methotrexate treatment of unruptured ectopic pregnancy: A report of 100 cases, Obstet Gynecol, 77, pp. 749-753, (1991)

[5]

Lindblom B, Hahlin M, Kallfelt B, Hamberger L., Local prostaglandin F<sub>2</sub>cc injection for termination of ectopic pregnancy, Lancet, 1, pp. 776-777, (1987)

[6]

Vejtorp M, Vejerslev LO, Ruge S., Local prostaglandin treatment of ectopic pregnancy, Hum Reprod, 4, pp. 464-467, (1989)

[7]

Timor-Tritsch IE, Yeh MN, Peisner DB, Lesser KB, Siavik TA., The use of transvaginal ultrasonography in the diagnosis of ectopic pregnancy, American Journal of Obstetrics and Gynecology, 161, pp. 157-161, (1989)

[8]

Anandakumar C, Lee CSS, Wong YC, Chia D, Rodenburg A, Ratnam SS., Accuracy in diagnosis of ectopic pregnancy by transvaginal ultrasonography, Asia-Oceania J Obstet Gynaecol, 18, pp. 107-113, (1992)

[9]

Ory SJ, Villanueva AL, Sand PK, Tamura RK., Conservative treatment of ectopic pregnancy with methotrexate, Am J Obstet Gynecol, 154, pp. 1299-1306, (1986)

[10]

Rodi IA, Sauer MV, Gorrill MI, Et al., The medical treatment of unruptured ectopic pregnancy with methotrexate and citrovorum rescue: preliminary experience, Fertil Steril, 46, pp. 811-813, (1986)

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