Abstract：
BACKGROUND: Methotrexate (MTX) is used in clinical practice as a medical treatment option in patients with early pregnancy complications like ectopic pregnancy.
OBJECTIVE: To review systemic MTX therapy use in the first trimester of pregnancy in our hospital and to examine subsequent clinical outcomes.
METHODS: Retrospective review of all women treated with systemic MTX in early pregnancy identified from electronic prescription records from 1 January 2018 to 31 December 2020 at Cork University Maternity Hospital, Ireland. Relevant data was transcribed from electronic health records.
RESULTS: Indications for treatment were tubal ectopic pregnancy (70%, n = 51), persistent pregnancy of unknown location (22%, n = 16) and caesarean scar pregnancy (7%, n = 5). Treatment was successful in 88% (n = 44) of tubal ectopic pregnancies with 73% (n = 37) and 14% (n = 7) of women receiving a single dose and repeated doses, respectively. Only 8% (n = 4) of tubal ectopic pregnancies required emergency surgery for subsequent tubal rupture. In 93% (n = 15) of cases of persistent pregnancy of unknown location, treatment was successful with one patient requiring uterine evacuation. Women with caesarean scar pregnancy were treated with combined MTX and uterine evacuation without complication.
CONCLUSIONS: The efficacy of medical treatment with systemic MTX for confirmed tubal ectopic pregnancy in our hospital is in line with national and international standards. Careful consideration should be given to treating caesarean scar pregnancy and persistent pregnancy of unknown location with systemic MTX. Systemic MTX use guided by clinicians specialised in early pregnancy complications and safe medication practices may improve treatment success and reduce adverse events.
OBJECTIVE: To review systemic MTX therapy use in the first trimester of pregnancy in our hospital and to examine subsequent clinical outcomes.
METHODS: Retrospective review of all women treated with systemic MTX in early pregnancy identified from electronic prescription records from 1 January 2018 to 31 December 2020 at Cork University Maternity Hospital, Ireland. Relevant data was transcribed from electronic health records.
RESULTS: Indications for treatment were tubal ectopic pregnancy (70%, n = 51), persistent pregnancy of unknown location (22%, n = 16) and caesarean scar pregnancy (7%, n = 5). Treatment was successful in 88% (n = 44) of tubal ectopic pregnancies with 73% (n = 37) and 14% (n = 7) of women receiving a single dose and repeated doses, respectively. Only 8% (n = 4) of tubal ectopic pregnancies required emergency surgery for subsequent tubal rupture. In 93% (n = 15) of cases of persistent pregnancy of unknown location, treatment was successful with one patient requiring uterine evacuation. Women with caesarean scar pregnancy were treated with combined MTX and uterine evacuation without complication.
CONCLUSIONS: The efficacy of medical treatment with systemic MTX for confirmed tubal ectopic pregnancy in our hospital is in line with national and international standards. Careful consideration should be given to treating caesarean scar pregnancy and persistent pregnancy of unknown location with systemic MTX. Systemic MTX use guided by clinicians specialised in early pregnancy complications and safe medication practices may improve treatment success and reduce adverse events.
摘要：
背景：甲氨蝶呤（MTX）在临床实践中用作异位妊娠等早期妊娠并发症患者的药物治疗选择。
目的：回顾我院妊娠早期全身MTX治疗的使用情况，并检查随后的临床结局。
方法：从2018年1月1日至2020年12月31日在科克大学妇产医院的电子处方记录中确定的所有妊娠早期接受全身性MTX治疗的妇女的回顾性回顾。爱尔兰。相关数据是从电子健康记录中转录的。
结果：治疗指征为输卵管异位妊娠（70％，n=51),不明位置的持续性妊娠(22%，n=16）和剖宫产瘢痕妊娠（7%，n=5)。88％（n=44）的输卵管异位妊娠成功治疗，其中73％（n=37）和14％（n=7）的妇女接受单剂量和重复剂量。分别。只有8％（n=4）的输卵管异位妊娠需要紧急手术治疗随后的输卵管破裂。在93％（n=15）的不明位置的持续性妊娠病例中，1例需要子宫排空的患者治疗成功.剖宫产瘢痕妊娠患者采用MTX联合子宫排空术治疗，无并发症发生。
结论：我院应用全身MTX治疗输卵管异位妊娠的疗效符合国内外标准。对剖宫产瘢痕妊娠和不明部位持续性妊娠应慎重考虑。由专门从事早期妊娠并发症和安全用药实践的临床医生指导的全身性MTX使用可以提高治疗成功率并减少不良事件。
目的：回顾我院妊娠早期全身MTX治疗的使用情况，并检查随后的临床结局。
方法：从2018年1月1日至2020年12月31日在科克大学妇产医院的电子处方记录中确定的所有妊娠早期接受全身性MTX治疗的妇女的回顾性回顾。爱尔兰。相关数据是从电子健康记录中转录的。
结果：治疗指征为输卵管异位妊娠（70％，n=51),不明位置的持续性妊娠(22%，n=16）和剖宫产瘢痕妊娠（7%，n=5)。88％（n=44）的输卵管异位妊娠成功治疗，其中73％（n=37）和14％（n=7）的妇女接受单剂量和重复剂量。分别。只有8％（n=4）的输卵管异位妊娠需要紧急手术治疗随后的输卵管破裂。在93％（n=15）的不明位置的持续性妊娠病例中，1例需要子宫排空的患者治疗成功.剖宫产瘢痕妊娠患者采用MTX联合子宫排空术治疗，无并发症发生。
结论：我院应用全身MTX治疗输卵管异位妊娠的疗效符合国内外标准。对剖宫产瘢痕妊娠和不明部位持续性妊娠应慎重考虑。由专门从事早期妊娠并发症和安全用药实践的临床医生指导的全身性MTX使用可以提高治疗成功率并减少不良事件。
