Analyzing the clinical significance of postoperative methotrexate in the management of early abdominal pregnancy: analysis of 10 cases

Ginekol Pol. 2019;90(8):438-443. doi: 10.5603/GP.2019.0078.

Abstract

Objectives: To assess the clinical value and treatment outcomes of postoperative methotrexate (MTX) therapy in themanagement of early abdominal pregnancy.

Material and methods: We retrospectively analyzed ten (10) cases of early abdominal pregnancy at our hospital between7th August, 2006 and 20th April, 2017.

Results: Out of the ten (10) cases identified, six (6) patients and four (4) patients underwent surgery (laparotomy or laparoscopy)only and surgery (laparotomy or laparoscopy) plus IM 50 mg/m2 methotrexate (MTX) within 24 hours of surgeryrespectively. The gestation age and serum β-HcG levels were significantly lower (p < 0.05, 6.0 ± 1.82 and 8073.2 ± 9561.0)in the surgery plus MTX group in comparison to (7.33 ± 3.61 and 15625 ± 21275.2) for the surgery only group. Ultrasoundimaging findings reported extra uterine pregnancy in all cases and diagnostic surgery was necessary to locate precise siteof implantation to plan further treatment. Days of hospitalization were shorter in the surgery + MTX group than in thesurgery only group (3.00 ± 0.816 versus 5.66 ± 2.80).

Conclusions: Earliness in diagnosis coupled with the appropriate (methotrexate) MTX regime could help prevent unwantedcomplications that could arise from delayed or misdiagnosis.

Keywords: abdominal ectopic pregnancy; diagnostic laparoscopy; early abdominal pregnancy; methotrexate; serum β-HcG.

Publication types

  • Case Reports
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortifacient Agents, Nonsteroidal / therapeutic use*
  • Adolescent
  • Adult
  • China
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Early Diagnosis
  • Female
  • Humans
  • Laparoscopy / methods*
  • Laparotomy / methods*
  • Methotrexate / therapeutic use*
  • Postoperative Period
  • Pregnancy
  • Pregnancy, Abdominal / drug therapy*
  • Pregnancy, Abdominal / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Abortifacient Agents, Nonsteroidal
  • Chorionic Gonadotropin, beta Subunit, Human
  • Methotrexate