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首页> 外文期刊>Canadian Journal of Emergency Medicine >Methotrexate for the treatment of unruptured tubal ectopic pregnancy
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Methotrexate for the treatment of unruptured tubal ectopic pregnancy

机译：甲氨蝶呤治疗未破裂的输卵管异位妊娠

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ObjectiveThe objective of this study was to determine the outcomes of women who presented to the emergency department (ED) with suspected ectopic pregnancy and received methotrexate as first-line treatment.MethodsThis was a retrospective chart review of pregnant (& 12 week’ gestational age) women from an academic tertiary care ED with a diagnosis of ectopic pregnancy, rule-out ectopic pregnancy, or pregnancy of unknown location over a 7-year period.ResultsOf 612 patients with a suspected ectopic pregnancy at initial ED presentation, 326 (53.3%) had non-ectopic pregnancy outcomes, 30 (4.9%) were diagnosed with a ruptured ectopic pregnancy at the index ED visit, and 18 (2.9%) were diagnosed and managed as non-tubal ectopic pregnancies and excluded from further analyses; 238 patients were diagnosed with a tubal ectopic pregnancy, and 152 (63.9%) were treated with methotrexate at the index ED visit or in follow-up. Of patients treated with methotrexate, 27 (17.8%) went on to require surgical management, with 17 (11.2%) documented as having ruptured on surgical evaluation.ConclusionThe proportion of patients failing methotrexate as first-line treatment was higher than previously reported. Further investigation is needed to determine whether methotrexate failure was due to non-adherence to recommended guidelines.
机译：目的本研究的目的是确定因疑似异位妊娠而就诊至急诊科并接受甲氨蝶呤作为一线治疗的妇女的结局。 ），在7年内被诊断为异位妊娠，排除性异位妊娠或位置不明怀孕的三级学术ED妇女结果612名在ED初次就诊时疑似异位妊娠的患者为326名（53.3％ ）具有非异位妊娠结局，在ED访视时被诊断为异位妊娠破裂的患者有30名（4.9％），被诊断为非输卵管异位妊娠并进行了管理，因此排除了进一步的分析; 238名被诊断为输卵管异位妊娠的患者，在ED访视或随访时接受甲氨蝶呤治疗152例（63.9％）。在接受甲氨蝶呤治疗的患者中，有27名（17.8％）继续需要手术治疗，有17名（11.2％）的患者因手术评估而破裂。结论一线治疗失败的甲氨蝶呤患者的比例高于先前报道。需要进一步调查以确定甲氨蝶呤失败是否是由于未遵守推荐的指南。

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