TITLE:
Methotrexate Treatment of Ectopic Pregnancy: Prognosis at Senlis Hospital
AUTHORS:
Kossi Edem Logbo-Akey, Kignomon Bingo M’bortche, Pierre Yendoubé Kambote, Dédé Régine Diane Ajavon, Kibandou Noe Patidi, Koko Gueze, Abdoul-Samadou Aboubakari
KEYWORDS:
Ectopic Pregnancy, Methotrexate, Prognosis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.10,
October
31,
2022
ABSTRACT: Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient
if it is ignored. Diagnosed early, it offers the possibility of medical
treatment with methotrexate. Objective: To describe the prognosis of
ectopic pregnancies treated methotrexate. Patients and Methods:
Retrospective study of the management of ectopic pregnancy by Methotrexate at
Senlis hospital from June 2020 to May 2021 were included in the study, patients
with a Fernandez score of less than 13, and having received Methotrexate as first-line
treatment. Data were collected using gynecological emergency admission
registers, and telephone interviews. Results: 35 cases were identified.
The average age of the patients was 32 years old. Forty-nine percent were
smokers. The mean gestational age was 5 weeks + 2 days. The diagnosis was made
in all of our patients with the combination of the kinetics of ß-hcg and
vaginal ultrasound. The size of adnexal mass was less than 4 cm with an average
size of 20 mm. The average value of ß-hcg was 1405 IU/L. All patients had received a single dose of methotrexate 1
mg/kg intramuscularly. A second dose was administered to 17.1% of patients for
stagnation or re-ascension of the ß-hcg level. The success rate was
91.4%. Thirty percent were obtained spontaneous intra uterine pregnancy, the
first year following methotrexate treatment. Conclusion: The success
rate of medical treatment for ectopic pregnancy is high in terms of meeting the
eligibility criteria for treatment. The subsequent prognosis of fertility is generally
preserved.