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首页> 外文期刊>European Journal of Obstetrics, Gynecology and Reproductive Biology: An International Journal >Medical therapy (methotrexate and mifepristone) alone or in combination with another type of therapy for the management of cervical or interstitial ectopic pregnancy
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Medical therapy (methotrexate and mifepristone) alone or in combination with another type of therapy for the management of cervical or interstitial ectopic pregnancy

机译：单独使用药物疗法（甲氨蝶呤和米非司酮）或与另一种类型的药物结合治疗宫颈或间质性异位妊娠

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Objective: To describe cases of cervical or interstitial ectopic pregnancy managed conservatively with combined medical treatment (methotrexate and mifepristone) alone or in association with other minimally invasive strategies. Study design: We describe four cervical and two interstitial ectopic pregnancies at our hospital between 2006 and 2010. All received combined treatment with methotrexate and mifepristone. A search of MEDLINE is also described. Results: The literature search identified only four previous cases of cervical ectopic pregnancies and no cases of interstitial ectopic pregnancy managed with combined therapy. In our study, all patients were successfully treated and had no adverse reactions with intramuscular methotrexate 50 mg/m2 and oral mifepristone 600 mg, either alone or in association with minimally invasive treatment (uterine artery embolization and evacuation dilation and curettage). All patients remained asymptomatic with β-HCG levels that decreased and became negative within 14-49 days: the median hospital stay was 5.5 days. We also describe the first patient with a cervical ectopic pregnancy treated with methotrexate and mifepristone, followed by vaginal misoprostol 800 mcg for cervical evacuation. Conclusion: Methotrexate-mifepristone, either alone or in combination with other minimally invasive strategies, could be considered an option for the treatment of both cervical and interstitial ectopic pregnancy. An individualized approach should be used in each patient, however, given the wide variety of possible clinical situations and the potential seriousness of ectopic pregnancy.
机译：目的：描述单独或结合其他微创策略保守治疗并联合治疗（甲氨蝶呤和米非司酮）的宫颈或间质性异位妊娠病例。研究设计：我们描述了2006年至2010年间在我们医院进行的四次宫颈癌和两次间质性异位妊娠。所有患者均接受甲氨蝶呤和米非司酮的联合治疗。还描述了对MEDLINE的搜索。结果：文献检索仅发现以前的四例宫颈异位妊娠病例，没有合并疗法治疗间质性异位妊娠的病例。在我们的研究中，所有患者均单独或与微创治疗（子宫动脉栓塞，排空扩张和刮除术）联合使用了50 mg / m2的氨甲蝶呤和600 mg的米非司酮口服治疗，均无不良反应。所有患者均无症状，β-HCG水平在14-49天内下降并变为阴性：中位住院天数为5.5天。我们还描述了首例接受甲氨蝶呤和米非司酮治疗的宫颈异位妊娠患者，然后使用800 mcg的阴道米索前列醇进行宫颈排空。结论：甲氨蝶呤-米非司酮，单独或与其他微创治疗策略联用，可被视为宫颈和间质性异位妊娠的治疗选择。但是，考虑到各种可能的临床情况以及异位妊娠的潜在严重性，应该对每位患者使用个体化方法。

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