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- Title
Effectiveness of expectant management versus methotrexate in tubal ectopic pregnancy: a double-blind randomized trial.
- Authors
Silva, Priscila; Araujo Júnior, Edward; Cecchino, Gustavo; Elito Júnior, Julio; Camano, Luiz
- Abstract
Purpose: To compare the effectiveness of expectant management versus methotrexate in selected cases of tubal ectopic pregnancy. Methods: A double-blind randomized trial included 23 selected patients with a confirmed diagnosis of tubal pregnancy who met the inclusion criteria (hemodynamic stability, initial serum β-hCG concentration <2,000 mIU/mL, declining titers of β-hCG 48 h prior to treatment, visible tubal pregnancy on transvaginal ultrasound, a tubal mass <5.0 cm and fertility desire). The patients were divided into two groups: 10 patients in the methotrexate group (MTX 50 mg/m administered as a single intramuscular dose) and 13 patients in the placebo group (saline solution administered in a single intramuscular dose). Quantitative variables were expressed as means ± standard deviations and compared by Student's t test or Mann-Whitney test. Dichotomous variables (success/treatment failure) were presented as proportions and compared by the Fisher exact test. Results: Successful treatment with negative titers of β-hCG occurred in 9 cases (90.0 %) of the methotrexate group and in 12 (92.3 %) of the placebo group ( p > 0.999). The β-hCG values became undetectable at 22 ± 15.4 days in the methotrexate group and 20.6 ± 8.4 days in the placebo group ( p = 0.80). Conclusion: This study showed no statistically significant difference between the treatment with methotrexate and placebo, with similar success rates and similar time interval for β-hCG to become undetectable.
- Subjects
METHOTREXATE; ECTOPIC pregnancy; CLINICAL trials; COMPARATIVE studies; HEMODYNAMICS
- Publication
Archives of Gynecology & Obstetrics, 2015, Vol 291, Issue 4, p939
- ISSN
0932-0067
- Publication type
Article
- DOI
10.1007/s00404-014-3513-0