Mehmet OBUT, MUHAMMED HANİFİ BADEMKIRAN, Sedat AKGÖL, Bekir KAHVECI, Ihsan BAGLI, S. Cemil OĞLAK, MEHMET ŞÜKRÜ BUDAK

ASSESSMENT OF METHOTREXATE EFFICACY IN THE TREATMENT OF ECTOPIC PREGNANCY

Aim:Our aim in this study was to assess efficacy of single- dose methotrexate (MTX) as medical treatment for ectopic pregnancy (EP) by evaluating the results of patients given this treatment. Materials and Methods:Between September 2016 and August 2017, the treatment outcomes of EP cases treated with MTX at Gazi Yaşargil Training and Research Hospital of Health Sciences University were evaluatedretrospectively. Results:In total, 126 cases treated for EP were evaluated and 65 cases were included in the study. In cases administered a single dose of MTX, the success rate was 80%, the failure rate was 13.8%, and the emergency surgery rate was 6.2%. The overall success rate of the medical treatment was 90.7% for a second dose of MTX. An unsuccessful result was considered as less than a 15% reduction in the beta-human chorionic gonadotropin (β-hCG) level between 4 and 7 days after single dose MTX administration. In all cases, the rate of emergency surgery after treatment was 9.3%. Conclusions:In our study, success rates in patients with EP treated with MTX were 80% after a single dose and as high as 90.7% when a second dose was added.

Ektopik Gebelik Olgularında Methotrexatın Tedavi Etkinliğinin Değerlendirilmesi

Amaç:Bu çalışmadaki amacımız ektopik gebelik’ te (EP) medikal tedavi olarak tek doz methotrexat (MTX) tedavisi verilen olguların sonuçlarının değerlendirilmesidir. Materyal ve Metot:Eylül 2016 ile Ağustos 2017 arasında Sağlık Bilimleri Üniversitesi Gazi Yaşargil Eğitim ve Araştırma Hastanesinde tedavi edilen EP olgularında MTX tedavisi uygulanmış olanların tedavi sonuçları retrospektif olarak değerlendirildi. Bulgular:Çalışmanın yapıldığı tarihler arasında EP nedeniyle tedavi edilen 126 olgu çalışmaya dahil edildi. Tek doz MTX tedavisi başlanan olgularda başarı oranı %80, başarısızlık %13.8 ve acil cerrahi oranı %6.2 olarak gerçekleşti. Tek doz MTX uygulaması sonrasında 4 ve 7 günler arsında beta- human chorionic gonadotropin (β-hCG) seviyesinin %15 ten az düşmesi sonucunda başarısız olarak kabul edilen olgularda yapılan 2. doz MTX sonucunda, medikal tedavinin toplam başarı oranı %90.7 olarak gerçekleşirken, bu olguların tümünde tedavi sonrası acil cerrahi oranı %9.3 olarak gerçekleşti. Sonuç:Çalışmamızda uygun endikasyonla MTX tedavisi uygulanan EP olgularında medikal tedavinin başarı oranı %90.7 gibi oldukça yüksek bir oranda gerçekleşmiş olup olguların sadece %9.3 de MTX tedavisi sonrasında acil cerrahi tedavigerekmiştir.

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