Tubal ektopik gebeliklerde çoklu doz metotreksat tedavisinin analizi

Amaç: Tubal ektopik gebelik hastalarında ardışık çoklu doz metotreksat tedavisinin başarı oranı ile tedavi başarısına etki eden prognostik faktörlerin belirlenmesi hedeflenmiştir. Gereç ve Yöntem: Bu retrospektif çalışmada 2017-2020 yılları arasında tersiyer merkezimizde ektopik gebelik tanısı ile hospitalize edilmiş ve ardışık çoklu doz metotreksat tedavi protokolü uygulanmış 63 hastanın klinik, labaratuvar ve demografik verileri analiz edilmiştir. Bulgular: Hastaların 45’inde medikal tedavi ile başarılı olunmuştur. Metotreksat protokolü ile başarısız olunan hastaların %88.8’inde (n=16) takip sırasında tubal rüptür nedeni ile cerrahi operasyon ihtiyacı gelişmiştir. Medikal tedavi ile başarılı olunan grupta başvuru anında Douglas’ta serbest mayi ortalaması 2.40±0.70 mm (Ort.±SH); başarısız olunan grupta 10.38±3.05 mm (Ort.±SH) bulunmuştur. Medikal tedavi ile başarılı olunan grubun başvuru β-hCG düzeyi 3668.55±440.55 IU/L (Ort.±SH); başarısız olunan grubunki 4929.72±752.65 IU/L (Ort.±SH) bulunmuştur. Sonuç: Ardışık çoklu doz metotreksat protokolünün başarı oranı %71.4 olarak saptanmıştır. Medikal tedavi ile başarısız olunan grupta başlangıç serum β-hCG düzeyinin yüksek olduğu, yine ilk başvuruda Douglas’ta sonografik olarak ölçülen serbest sıvı miktarının yüksek olduğu tespit edilmiştir.

Analysis of multiple-dose methotrexate therapy in tubal ectopic pregnancies

Purpose: The study aimed at determining the success rate of sequential multi-dose methotrexate treatment in tubal ectopic pregnancy (EP) patients and the prognostic factors affecting the treatment success. Materials and Methods: Clinical, laboratory, and demographic data of 63 patients -hospitalized with the diagnosis of EP in our tertiary center between 2017-2020 and administered sequential multiple-dose methotrexate treatment protocol- were analyzed in this retrospective study. Results: Based on research findings, medical treatment was successful in 45 of the patients. It was found that 16 out of 18-patient, 88.8% of the patients in the failed group with methotrexate treatment, were operated on due to tubal rupture during follow-up. The mean of sonographic free fluid in Douglas of the successful group with methotrexate treatment was found to be 2.40±0.70 mm (Mean±SE), while it was 10.38±3.05 mm (Mean±SE) in the failed group at the first consultation. The initial β-hCG value of the successful group with methotrexate treatment was measured 3668.55±440.55 IU/L (Mean±SE), while it was 4929.72±752.65 IU/L (Mean±SE) in the failed group. Conclusion: The success rate of the sequential multiple dose methotrexate protocol was 71.4%. Both the initial serum β-hCG level and the amount of sonographic free fluid in the pouch of Douglas were found high in the failed group with medical treatment at the first consultation.

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Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi
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