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논문 기본 정보

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학술저널
저자정보
Kim, Kidong (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) Suh, Dong Hoon (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) Cheong, Hyun Hoon (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) Yoon, Sang Ho (Department of Obstetrics and Gynecology, Graduate School of Medicine, Dongguk University) Lee, Taek-Sang (Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center) No, Jae Hong (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) Kim, Yong-Beom (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital)
저널정보
대한생식의학회 Clinical and experimental reproductive medicine : CERM Clinical and experimental reproductive medicine : CERM 제41권 제1호
발행연도
2014.1
수록면
33 - 36 (4page)

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Objective: To estimate the failure rate of medical treatment and to identify variables associated with treatment failure in patients with tubal pregnancy and an initial serum level of human chorionic gonadotropin (HCG) over 10,000 IU/L. Methods: The inclusion criteria were tubal pregnancy diagnosed using ultrasonography, primary treatment of intramuscular methotrexate injection at one of the four institutions between January 2003 and December 2011, a serum HCG level within two days before treatment >10,000 IU/L, and follow-up data to determine treatment success or failure. Exclusion criteria were other primary treatments besides intramuscular methotrexate injection. The clinicopathologic data of 36 patients were collected and analyzed. Results: Medical treatment failed and surgery was performed in 19 (53%) patients. In univariable analysis, age, parity, and size of the gestational sac were associated with treatment failure, but none of the variables were associated with treatment failure in multivariable analysis. The failure rate in the subgroup with age<33 years and size of gestational sac ${\geq}1.1cm$ was significantly higher than those of the other subgroups (82% vs. 41% [mean of the other subgroups], respectively). Conclusion: Patients with a serum HCG level >10,000 IU/L who received medical treatment had a high failure rate. Among them, patients aged<33 year and with a gestational sac ${\geq}1.1cm$ had an extremely high failure rate.
#Tubal pregnancy #Methotrexate #Chorionic gonadotropin #Treatment failure

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참고문헌 (12)

참고문헌 신청
Voedisch AJ / 2012 / Berek & Novak’s gynecology / Wolters Kluwer Health/Lippincott Williams & Wilkins :873~924 google schola Menon S / 2007 / Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review / Fertil Steril 87:481~484 google schola American College of Obstetricians and Gynecologists / 2008 / ACOG Practice Bulletin No. 94: medical management of ectopic pregnancy / Obstet Gynecol 111:1479~1485 google schola Lipscomb GH / 1999 / Predictors of success of methotrexate treatment in women with tubal ectopic pregnancies / N Engl J Med 341:1974~1978 google schola Nguyen Q / 2010 / Are early human chorionic gonadotropin levels after methotrexate therapy a predictor of response in ectopic pregnancy? / Am J Obstet Gynecol 202:630 google schola

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