Effectiveness of conservative medical treatment for non-tubal ectopic pregnancies a multicenter study - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Journal of Gynecology Obstetrics and Human Reproduction Année : 2020

Effectiveness of conservative medical treatment for non-tubal ectopic pregnancies a multicenter study

Résumé

Objective To assess the effectiveness of conservative treatment for the management of non-tubal ectopic pregnancies (NTEP) Methods Retrospective cohort study in three centers (two referral centers) of patients managed for NTEP diagnosed by 2D or 3D ultrasonograhy. Patients underwent one of the following expectant management, systemic methotrexate (MTX) injection, local MTX injection, combined MTX injection (local and systemic), local injection of hyperosmolar glucose, or misoprostol administration. The primary endpoint was final success defined by resolution of hCG level without need for emergency surgical treatment. Sixty-four patients diagnosed with NTEP were included 37 (57%) had an interstitial pregnancy, 23 (35.9%) a cesarean scar pregnancy, two (3.1%) a cervical pregnancy and two (3.1%) an ovarian pregnancy. Results Six patients (9.4%) underwent expectant management, 24 (37.5%) a systemic MTX injection, 28 (43.8%) a local injection of MTX, three (4.7%) a combined MTX injection, one (1.6%) a local injection of hyperosmolar glucose (1.6%), and two (3.1%) were administered misoprostol. The median age was 32 years (22-45) and mean follow-up was 41 months. The final success rate overall was 92.2% 100% for expectant management, 87.5% for systemic MTX, 96.4% for local MTX, 100% for combined injection of MTX, 100% for local injection of hyperosmolar glucose, and 50% for misoprostol. No patient required a hysterectomy. Nine (14.1%) patients required surgery, including five (7.8% (5/64)) following a rupture of the NTEP. Conclusions Our results suggest that conservative medical management of NTEP is effective and safe and should be the first-line treatment for pauci-symptomatic patients with an NTEP.
Fichier principal
Vignette du fichier
Delplanque effectiveness of conservative medical.pdf (2.16 Mo) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Loading...

Dates et versions

hal-02638430 , version 1 (17-07-2020)

Identifiants

Citer

S. Delplanque, M. Le Lous, M. Flévin, E. Bauville, P.Y. Moquet, et al.. Effectiveness of conservative medical treatment for non-tubal ectopic pregnancies a multicenter study. Journal of Gynecology Obstetrics and Human Reproduction, 2020, 49 (10), pp.101762. ⟨10.1016/j.jogoh.2020.101762⟩. ⟨hal-02638430⟩
101 Consultations
258 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More