Abstract：
To compare Expectant management to systemic methotrexate in the management of persistent pregnancy of unknown location with beta-hCG levels below the discrimination zone.
A retrospective cohort study was conducted on 71 women with persistent pregnancy of unknown location. They were divided into two groups according to the applied management; Group 1, (n = 40) who were managed expectantly and Group 2 (n = 31) who were given a single dose of methotrexate. Data variables were collected and analyzed to evaluate whether expectant management was as effective as methotrexate.
There was no significant difference between the two groups regarding age, parity, gestational age, body mass index and day seven beta-hCG. Success rates were (32 patients (80%) and 28 patients (90.3%) in expectant management and methotrexate groups, respectively (P > 0.05). The mean values for day zero and day four beta-hCG were significantly higher and the mean duration for complete recovery was statistically shorter in the methotrexate group (P < 0.05). There were no significant differences between the two groups regarding prior ectopic, percentage of beta-hCG level drop on day four and day seven, success rate, occurrence of sequelae and patient satisfaction that area under the curve (AUC) for group 1 (expectant management) is 0.566 at 95% Confidence Interval of (0.388: 0.745).
Expectant management is an effective and safe alternative to single-dose methotrexate for persistent PUL with beta-hCG levels below the discrimination zone.
A retrospective cohort study was conducted on 71 women with persistent pregnancy of unknown location. They were divided into two groups according to the applied management; Group 1, (n = 40) who were managed expectantly and Group 2 (n = 31) who were given a single dose of methotrexate. Data variables were collected and analyzed to evaluate whether expectant management was as effective as methotrexate.
There was no significant difference between the two groups regarding age, parity, gestational age, body mass index and day seven beta-hCG. Success rates were (32 patients (80%) and 28 patients (90.3%) in expectant management and methotrexate groups, respectively (P > 0.05). The mean values for day zero and day four beta-hCG were significantly higher and the mean duration for complete recovery was statistically shorter in the methotrexate group (P < 0.05). There were no significant differences between the two groups regarding prior ectopic, percentage of beta-hCG level drop on day four and day seven, success rate, occurrence of sequelae and patient satisfaction that area under the curve (AUC) for group 1 (expectant management) is 0.566 at 95% Confidence Interval of (0.388: 0.745).
Expectant management is an effective and safe alternative to single-dose methotrexate for persistent PUL with beta-hCG levels below the discrimination zone.
摘要：
目的：比较在β-hCG水平低于区分区的不明部位持续性妊娠的治疗中，预期治疗与全身甲氨蝶呤的治疗。
方法：对71例不明部位持续妊娠的妇女进行了一项回顾性队列研究。根据应用的管理将他们分为两组；第1组（n=40）接受预期管理，第2组（n=31）接受单剂量甲氨蝶呤。收集并分析数据变量，以评估预期管理是否与甲氨蝶呤一样有效。
结果：两组之间的年龄没有显着差异，奇偶校验，胎龄,体重指数和第七天β-hCG。成功率为（32例患者（80％）和28例患者（90.3％）在期待管理和甲氨蝶呤组，分别为(P>0.05)。甲氨蝶呤组第0天和第4天β-hCG的平均值明显较高，完全恢复的平均持续时间在统计学上较短（P<0.05）。两组在先前的异位上没有显着差异，第四天和第七天β-hCG水平下降的百分比，成功率,在95%置信区间为(0.388:0.745)时,第1组(预期管理)的曲线下面积(AUC)为0.566。
结论：对于β-hCG水平低于区分区的持续性PUL，预期管理是单剂量甲氨蝶呤的有效且安全的替代方案。
方法：对71例不明部位持续妊娠的妇女进行了一项回顾性队列研究。根据应用的管理将他们分为两组；第1组（n=40）接受预期管理，第2组（n=31）接受单剂量甲氨蝶呤。收集并分析数据变量，以评估预期管理是否与甲氨蝶呤一样有效。
结果：两组之间的年龄没有显着差异，奇偶校验，胎龄,体重指数和第七天β-hCG。成功率为（32例患者（80％）和28例患者（90.3％）在期待管理和甲氨蝶呤组，分别为(P>0.05)。甲氨蝶呤组第0天和第4天β-hCG的平均值明显较高，完全恢复的平均持续时间在统计学上较短（P<0.05）。两组在先前的异位上没有显着差异，第四天和第七天β-hCG水平下降的百分比，成功率,在95%置信区间为(0.388:0.745)时,第1组(预期管理)的曲线下面积(AUC)为0.566。
结论：对于β-hCG水平低于区分区的持续性PUL，预期管理是单剂量甲氨蝶呤的有效且安全的替代方案。
