Comparison of 2-year reproductive outcomes of tubal ectopic pregnancies treated with surgery, methotrexate or expectant management.

Autor: Fıratlıgil FB; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey. md.fahri@gmail.com., Sucu S; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey., Sucu ST; Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey., Ozkan MA; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey., Reis YA; Department of Obstetrics and Gynecology, Ankara Etlik Zubeyde Hanim Women's Health Education and Research Hospital, Ankara, Turkey., Dereli ML; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey., Ozkan S; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey., Engin-Ustun Y; Department of Obstetrics and Gynecology, Ankara Etlik Zubeyde Hanim Women's Health Education and Research Hospital, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2024 Nov; Vol. 310 (5), pp. 2561-2568. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1007/s00404-024-07747-0
Abstrakt: Introduction: To compare the 2-year reproductive outcomes of tubal ectopic pregnancies (EP) treated with surgery, methotrexate (MTX) or expectant management.
Materials and Methods: This case-control study was conducted retrospectively at the Obstetrics-Gynecology and Perinatology Clinics of Etlik Zubeyde Hanim Women's Health Education and Training Hospital. 985 of 1156 patients, who were managed between January 2015 and December 2019 for a tubal EP, tried to conceive in 2 years after treatment: 366 patients underwent surgical treatment; 549 patients were treated with MTX, and 70 patients had expectant management. Clinical data and fertility outcomes were retrieved by medical and hospital records. We compared the three groups based on the 2-year reproductive outcomes of three treatment modalities of tubal EP.
Results: There was a significant difference in the frequency of no pregnancy in patients who underwent surgery compared to patients who received expectant management and MTX therapy (p < 0.001). The frequency of no pregnancy was higher in patients who underwent surgery. There was no significant difference between expectant management and MTX therapy (p = 0.411). In the reproductive outcomes of patients who underwent surgery, the incidence of viable pregnancies was statistically lower than in the group treated with expectant management and MTX therapy (p = 0.003).
Conclusions: Patients with an EP often have a future desire to have children, the treatment options are also important. The earlier the diagnosis is made, the more likely it is that expectant management or MTX treatment will be considered. With these two treatment methods, the likelihood of having a child in the future is higher than with surgical treatment.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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