ULTRASOUND Messages for January, 1999: Re: methotrexate use for ectopic pg

Re: methotrexate use for ectopic pg

From: art fougner, md

evsono@pipeline.com

Thu Jan 7 20:37:19 1999

Analysis of three hundred fifteen ectopic pregnancies treated with single-dose methotrexate

Gary H. Lipscomb, MD [MEDLINE LOOKUP] Derita Bran, RN [MEDLINE LOOKUP] Marian L. McCord, MD [MEDLINE LOOKUP] J. Chris Portera, MD [MEDLINE LOOKUP] Frank W. Ling, MD [MEDLINE LOOKUP] Memphis, Tennessee

OBJECTIVES: The objective of this study was to review the largest single series of ectopic pregnancies treated with single-dose methotrexate reported to date. STUDY DESIGN: A review of 315 patients with unruptured ectopic pregnancies treated with single-dose methotrexate 50 mg/m2 from March 21, 1990, to March 1, 1997, was performed. RESULTS: Overall 287 patients were successfully treated with methotrexate for a success rate of 90.1%. Six patients electively withdrew and requested surgery within 1 week of starting therapy. Excluding withdrawals the overall success rate was 92.9%. Ten patients with an ectopic pregnancy >3.5 cm but 4 cm in size were treated for a 90% success rate. Forty-four patients with positive ectopic cardiac activity were treated with an 87.5% success rate. CONCLUSIONS: This large series indicates that single-dose intramuscular methotrexate for treatment of ectopic pregnancy is associated with an excellent overall success rate. (Am J Obstet Gynecol 1998;178:1354-8.)

If you like, can ftp the full article to the US site.

Art

At Thu, 7 Jan 1999, DuBose, Terry wrote: >
>Dear Audry, I am going to forward your question to the Ultrasound section of
>OBGYN.net you might want to go there and look for responses to the question.
>If you don't have access to the Web, remind me in a couple of days & and I
>will send you the messages.
>
>If you do have access to the web, go to:
>http://forums.obgyn.net/forums/ultrasound/ over the next two days and look
>at "Recent Messages" for the above Subject.
>
>Just for my interest, did you record the embryonic heart rate by M-mode. IF
>you did, what was the rate?
>
>Good luck.
>
>Peace, Terry J. DuBose, M.S., RDMS, FAIUM
>University of Arkansas for Medical Sciences, USA
>http://www.io.com/~dubose/
>http://www.uams.edu/CHRP/dmshome.htm
>http://www.obgyn.net/us/panel/dubose_us.htm
>
>---
>
>> -----Original Message-----
>> From: SOUNDHLTH@aol.com [SMTP:SOUNDHLTH@aol.com]
>> Sent: Thursday, January 07, 1999 4:24 PM
>> To: Sonographers-Connection@Lists.UCHSC.edu
>> Subject: methotrexate use for ectopic pg
>>
>> We had a patient come in today with a live ectopic. CRL= 5mm,(6wks)
>> gest.sac mean diameter 10.5mm(5.5 wks). There was a prominent ring
>> (decidua) around sac. I did not include that in measurement only measured
>> the cystic structure. Pt was not suspecting an ectopic. She has been
>> doing the infertility thing for past five years and Dr. ordered ultrasound
>> for her benefit and to alleve anxiety. It was a bummer to see an
>> ectopic. The Dr. thought that any ectopic with postive cardiac seen was
>> a contraindication for methotrexate. However, in my previous employment
>> we did use methotrexate when there was positive fetal cardiac. Can anyone
>> give me some info about criteria for using methotrexate for treatment of
>> ectopic pregnancies.
>> Thanks for the help.
>> Audrey RDMS<RDCS<RVT
>

-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com

Women's Insurance Checklist from Auto Insurance Quote

use when must restrict search to only the ultrasound forum...
Enter search keywords:
	Returns per screen: Require all keywords: