Endometrial thickness as an orienting factor for the medical treatment of unruptured tubal pregnancy.
OBJECTIVE
To evaluate the efficacy of the endometrial thickness measurement through transvaginal ultrasound as an orienting factor for the medical treatment of unruptured tubal pregnancy with a single dose of methotrexate in order to select the best cases for the medical treatment.


METHODS
A prospective study, in which the largest measurement of endometrial thickness in millimeters was evaluated, along the longitudinal uterine axis, by means of transvaginal ultrasound. A total of 38 patients meeting the inclusion criteria for single-dose methotrexate treatment [50 mg/m2 intramuscularly (i.m.)] were included in the study. We observed whether there was any difference in mean value of endometrial thickness and initial beta-human choriongonadotropin levels, between the cases that evolved successfully with the treatment, and those that failed.


RESULTS
The mean value of endometrial thickness and initial beta-human choriongonadotropin (beta-hCG) levels, for patients evolving successfully with medical treatment (28 cases), were 6.39 mm and 1936.2 mUI/ml, respectively, while the mean values for failures were 11.70 mm and 6831.3 mUI/ml. We carried out statistical analysis using the 'Student's t-test', with p < 0.05.


CONCLUSIONS
The mean value of endometrial thickness, along the longitudinal uterine axis through transvaginal ultrasound, reflects hormonal action and has been demonstrated to be another important parameter in indicating the medical treatment of an unruptured tubal pregnancy.
Department of Obstetrics, Federal University of São Paulo, Universidade Federal de São Paulo, São Paulo, Brazil. mychelyroberto@uol.com.br
Roberto
R
da Costa Soares
Júlio
J
Elito
Kyung Koo
KK
Han
Luiz
L
Camano
D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D019160:Endosonography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000188:drug therapy*; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate