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Which protocol is better for treatment of ectopic pregnancy by methotrexate? Single-dose or multiple-dose

机译:哪种方案更好地通过甲氨蝶呤治疗异位妊娠?单剂量或多剂量

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Background:Ectopic pregnancy (EP) is the most common cause of death in the first trimester of pregnancy. Methotrexate (MTX) is an acceptable treatment in the cases with the lack of tube rupture or no important one, which has reduced surgical treatment. Despite numerous studies, there is still no consensus about medications. The present study is aimed to evaluate the single- and multiple-dose of MTX among these patients.Materials and Methods:This clinical trial study was done on 108 EP patients who were selected for the systemic MTX treatment and divided into two groups. For the single-dose group, MTX was administered once and β human chorionic gonadotropin (βHCG) levels were measured first and then on days 4 and 7. In the multi-dose group, 1 mg/kg MTX was injected on days 1, 3, 5, and 7. In both groups, MTX was prescribed following these days if βHCG was not reduced. In the two groups, βHCG levels were assessed after 1 week. The success rate of treatment and complications were followed up and recorded up to 6 weeks after treatment.Results:The success rate in the single-dose and multiple-dose MTX group was 47% and 51%. The MTX level in the single dose group decreased from 2532 ± 1154 mIU/mL to 1341 ± 553 mIU/mL and in the multiple dose group from 2671 ± 2685 mIU/mL to 1313 ± 605 mIU/mL (P 0.05).Conclusion:Single and multi-dose regimen did not show a significant difference in terms of the success of treatment. Therefore, given that the lower dose of the drug associated with lower the risk of complications, it is safe to choose the single-dose regimen.
机译:背景:异位妊娠(EP)是怀孕孕期最常见的死亡原因。甲氨蝶呤(MTX)是在缺乏管破裂或没有重要的病例中的可接受的治疗方法,这减少了手术治疗。尽管有许多研究,但仍然没有关于药物的共识。本研究旨在评估这些患者中的单剂量和多剂量的MTX。材料和方法:在108名EP患者中进行了这种临床试验研究,被选择为全身MTX治疗并分为两组。对于单剂量组,施用MTX一次,首先测量β人绒毛膜促性腺激素(βHCG)水平,然后在第4天和7天中测量。在多剂量基团中,在第1天,3天注射1mg / kg MTX在这两个组中,如果βHCG未降低,则在这两次组中开辟了MTX。在两组中,1周后评估βHCG水平。治疗和并发症的成功率随访并在治疗后6周记录。结果:单剂量和多剂量MTX组的成功率为47%和51%。单剂量组中的MTX水平从2532±1154 mIU / ml降低至1341±553 mIU / mL,在多剂量组中,从2671±2685 mIU / ml到1313±605 miu / ml(p 0.05)。结论:单剂量和多剂量方案在治疗成功方面没有表现出显着差异。因此,考虑到较低剂量的药物与较低的并发症风险相关,选择单剂量方案是安全的。

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