Abstract
Author(s): Joanna Habaj, Adam Dyrda, Marlena Wojnarowska
Introduction. Ectopic pregnancy is the result of inappropriate embryo implantation affecting 1 -2 % of pregnancies. The frequency of this pathological form of pregnancy has been on the same level for years and still constitutes one of the most common causes of women’s death in childbearing age in undeveloped countries. Aim. The aim of the study was to assess the diagnosis of early ectopic pregnancy in potential childbearing patients and their qualification for methotrexate (MTX) treatment. Material and methods. The analysis includes patients of the Szpitala Powiatowego Centrum Zdrowia in Miko?ów in the years 2007 – 2017. Diagnosis of the ectopic pregnancy included a detailed history interview with highlighted chorionic gonadotropin combined with physical examination and assessment in transvaginal ultrasound examination. After observational study at women with confirmed early ectopic pregnancy, whose health and other factors weren’t a contraindication pharmacological method for methotrexate treatment in dose of 1mg/kg body weight was introduced. The Patients were informed about the treatment method, possible side effects and alternative treatments. They expressed informed consent for drug treatment. The necessity of second dose injection with methotrexate was not considered as a treatment failure. Women, from with various reasons couldn’t be included in the methotrexate treatment protocol, they were qualified to surgical proceedings, whose the dominant procedure was laparoscopy. Urgent laparotomy was performed in case of danger to life. Results. The analysis included 134 patients with diagnosed ectopic pregnancy within 10 years (2007 – 2017). A medical protocol of methotrexate treatment was used with 39 patients, of which 35 achieved complete remission, which accounts for 90% of those reported cases. Good drug tolerance was observed. The most common reported side effects symptoms include: general weakness, abdominal pain, nausea, diarrhea. Conclusion. The study shows that the level of chorionic gonadotropin and transvaginal ultrasound examination is a qualifying factor in early ectopic pregnancy for methotrexate treatment. It has also been shown that the therapy has a high effectiveness which can help to avoid surgical treatment.