Clinical outcomes of patients treated for cervical pregnancy with or without methotrexate.
The objective of this study is to describe the clinical outcomes of patients treated for cervical pregnancy with or without methotrexate (MTX) and to evaluate the effects of MTX in the treatment of cervical pregnancy. Between January 1993 and February 2000, 31 patients were diagnosed with cervical pregnancy. Twenty-two patients were treated with MTX chemotherapy and nine patients were treated with surgical procedures without MTX treatment. In the non-MTX treatment group, three patients underwent total abdominal hysterectomy, five required adjuvant procedures to control the bleeding during dilatation and curettage (D&C) and only one patient was treated with a simple D&C. In the MTX treatment group, fourteen (63.6%) patients were treated with only MTX and eight (36.4%) cases underwent concomitant procedures (simple curettage, curettage and Foley catheter tamponade, cervical cerclage, ligation of the descending branches of uterine arteries, or ligation of hypogastric arteries). The uterus was preserved in all cases and three women delivered healthy babies in their subsequent pregnancy. In conclusion, early diagnosis, appropriate MTX regimen in combination of necessary adjuvant conservative procedures could contribute to successful treatment with preservation of the uterus and future reproductive ability.
Kim
Tae Jin
TJ
Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Seong
Seok Ju
SJ
Lee
Keum Jung
KJ
Lee
Je Hoon
JH
Shin
Joong Sik
JS
Lim
Kyung Taek
KT
Chung
Hwan Wook
HW
Lee
Ki Heon
KH
Park
In Sou
IS
Shim
Jae Uk
JU
Park
Chong Taik
CT
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D004107:Dilatation and Curettage / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate