Mingyi Wang1, Biliang Chen2, Jian Wang2, Xiangdong Ma2, Yu Wang3. 1. Department of Obstetrics and Gynecology, General Hospital of the People's Liberation Army, Chengdu Military Region, China. 2. Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China. 3. Department of Obstetrics and Gynecology, General Hospital of the People's Liberation Army, Chengdu Military Region, China. Electronic address: wangyuog@163.com.
Abstract
STUDY OBJECTIVE: To evaluate outcomes relative to treatment using systemic methotrexate (MTX) alone or systemic MTX combined with ultrasound (US)-guided local injection of potassium chloride (KCl) or MTX in women with live tubal ectopic pregnancies. DESIGN: Case-control study (Canadian Task Force classification II-2). SETTING: Departments of Obstetrics and Gynecology in 2 hospitals in China. PATIENTS: Eighty-two women with live tubal ectopic pregnancies. INTERVENTION: Participants in the study received treatment using either systemic MTX (n = 37; systemic treatment group) or systemic MTX and US-guided local injection of either MTX or KCl (n = 45; combined treatment group). MEASUREMENTS AND MAIN RESULTS: Patient clinical features and outcomes were compared. There were no significant differences between the patient groups insofar as baseline gestational age, β-human chorionic gonadotropin concentration, or size of conceptus. The success rate in patients who received combined therapy (93.3%) was much higher than in those who received only systemic treatment (73.0%) (p < .05). In the combined treatment group, the success rate was similar between women who received locally injected KCl (95.2%) and those who received locally injected MTX (91.7%). CONCLUSION: The significantly higher success rate in patients who received combined US-guided local injection and systemic MTX suggests that this is an efficient nonsurgical option in women with tubal pregnancy, high serum β-human chorionic gonadotropin concentration, and fetal cardiac activity.
RCT Entities:
STUDY OBJECTIVE: To evaluate outcomes relative to treatment using systemic methotrexate (MTX) alone or systemic MTX combined with ultrasound (US)-guided local injection of potassium chloride (KCl) or MTX in women with live tubal ectopic pregnancies. DESIGN: Case-control study (Canadian Task Force classification II-2). SETTING: Departments of Obstetrics and Gynecology in 2 hospitals in China. PATIENTS: Eighty-two women with live tubal ectopic pregnancies. INTERVENTION: Participants in the study received treatment using either systemic MTX (n = 37; systemic treatment group) or systemic MTX and US-guided local injection of either MTX or KCl (n = 45; combined treatment group). MEASUREMENTS AND MAIN RESULTS:Patient clinical features and outcomes were compared. There were no significant differences between the patient groups insofar as baseline gestational age, β-human chorionic gonadotropin concentration, or size of conceptus. The success rate in patients who received combined therapy (93.3%) was much higher than in those who received only systemic treatment (73.0%) (p < .05). In the combined treatment group, the success rate was similar between women who received locally injected KCl (95.2%) and those who received locally injected MTX (91.7%). CONCLUSION: The significantly higher success rate in patients who received combined US-guided local injection and systemic MTX suggests that this is an efficient nonsurgical option in women with tubal pregnancy, high serum β-human chorionic gonadotropin concentration, and fetal cardiac activity.