title: Ectopic pregnancy treatment by combination therapy.
abstract: Detectability of early stages of ectopic pregnancies has increased due to improvements in ultrasonographic and biochemical techniques. Since the patients' future procreative plans must be taken into consideration when commencing treatment, the goal of this work was to compare the effects of treatment methods and their impact on fertility. The study included 91 patients treated surgically for ectopic pregnancy. The choice of treatment depended on patients' general condition, ultrasonographic evaluation and serum level of beta-hCG. A combination of laparoscopic and conservative systemic treatment was applied in 70% of cases. More rapid beta-hCG reduction was noted when laparoscopy and intra-oviductal injection of hyperosmolar glucose or methotrexate (MTX) were combined with intramuscular administration of MTX at a dose of 50 mg/m2. Follow-up examination of 66 patients revealed that the greatest number of spontaneous pregnancies (48%) resulted after this combination therapy. We conclude that this combination treatment is safe and provides satisfactory results in terms of future fertility.
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Cymbaluk-Płoska
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Anita
authors.initials: A
authors.lastname: Chudecka-Głaz
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Kuźniak
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Menkiszak
keywords: Ectopic pregnancy; Hyperosmolar glucose; Laparoscopy; Methotrexate injection