Reporte de un caso: tratamiento farmacológico del Embarazo Ectópico

Report of a case: pharmacological treatment of Ectopic Pregnancy

Authors

  • Stiward Velasco Jácome
  • Jorge Ramírez Romero
  • Adriana Campoverde Ávila
  • Maila Cando Rendón

Keywords:

Ectopic Pregnancy, pharmacological treatment, Metotrexato

Abstract

An ectopic pregnancy is defined when the fertilized oocyte implants outside the endometrial cavity. The incidence has increased in recent decades to reach 1-2%. Currently, the rupture of ectopic pregnancy continues to be an important cause of pregnancy-related morbidity and mortality, so their study is still relevant. The availability of highly sensitive methods of detecting gonadotrophins and the use of high-resolution transvaginal ultrasonography have made it possible to diagnose Ectopic Pregnancy earlier, allowing the use of less aggressive treatments such as the use of metotrexate. The case report presented in an adult patient of childbearing age, who attended the Gynecological Emergencies service of the General Hospital of Ibarra and received medical treatment with Metotrexate.
Conclusions: Metotrexate treatment has shown very good results with high success rates, allowing preserving maternal fertility and involving lower costs to the health system.

Downloads

Download data is not yet available.

References

Kurt T. Barnhart, MD, MSCE; and Jason M. Franasiak, MD, TS. Tubal ectopic pregnancy. ACOG Practice Bulletin No. 191. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018; 131:e65–77.

Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod. 2002 Dec; 17(12):3224-30.

Beera Neelima, V. G. Vanamala. Risk factors of ectopic pregnancy: a study in a tertiary care centre, June 2017, 10.18203/2320-1770.ijrcog20172589

Creanga AA, Syverson C, Seed K, Callaghan WM.Pregnancy-related mortality in the United States, 2011-2013. Obstet Gynecol 2017;130: 366–73.

Cabrera Samith Ignacio, Perales C Iván, Romero A Germán. Análisis Epidemiológico y Clínico del Embarazo Ectópico: Hospital Base de los Ángeles. Rev. chil. obstet. ginecol. [Internet]. 2010 [citado 2019 Jul 04]; 75(2): 96-100. Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0717-75262010000200004&lng=es. http://dx.doi.org/10.4067/S0717-75262010000200004.

Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol 2005; 105:1052.

Stulberg DB, Cain LR, Dahlquist I, Lauderdale DS. Ectopic pregnancy rates and racial disparities in the Medicaid population, 2004-2008. Fertil Steril 2014; 102:1671

Parker VL, et al. Non-tubal ectopic pregnancy. Arch GynecolObstet (2016) 294:19–27

Usandizaga José, De la Fuente Pedro. Obstetricia y Ginecología. 2 da edición. España. Marbán. 2011. pp: 310-320

Barnhart KT, Sammel MD, Gracia CR, Chittams J,Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies.Fertil Steril 2006;86:36–43

Ankum WM, Mol BW, Van der Veen F, Bossuyt PM.Risk factors for ectopic pregnancy: a meta-analysis. FertilSteril 1996;65:1093–9

Kamwendo F, Forslin L, Bodin L, Danielsson D. Epidemiology of ectopic pregnancy during a 28 year period and the role of pelvic inflammatory disease. Sex Transm Infect 2000; 76:28

Davies B, Turner KM, Frølund M, et al. Risk of reproductive complications following chlamydia testing: a population-based retrospective cohort study in Denmark. Lancet Infect Dis 2016; 16:1057

Backman T, Rauramo I, Huhtala S, Koskenvuo M.Pregnancy during the use of levonorgestrel intrauterine system. Am J Obstet Gynecol 2004; 190:50–4

Sivin I. Dose- and age-dependent ectopic pregnancy risks with intrauterine contraception. Obstet Gynecol 1991; 78:291

Li C, Zhao WH, Meng CX, et al. Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study. PLoS One 2014; 9:e115031

Larimore WL, Stanford JB. Postfertilization effects of oral contraceptives and their relationship to informed consent. Arch Fam Med 2000; 9:126.

Berek, Jonathan S. Berek y Novak Ginecología. 15 va edición. España. LIPPINCOTT CASTELLANO. 2013. pp. 421

Protocols Medicina Maternofetal. Hospital Clínic- Hospital Sant Joan de Déu- Universitat de Barcelona. Protocolo: Gestación Ectópica Tubárica y no tubárica. 2018. Disponible en: www.medicinafetalbarcelona.org

Barnhart K, Sammel MD, Chung K, Zhou L, Hummel AC, Guo W. Decline of serum human chorionic gonadotropin and spontaneous complete abortion: defining the normal curve. Obstet Gynecol 2004;104:975–81.

Kadar N, Romero R. Serial human chorionic gonadotropin measurements in ectopic pregnancy. Am J Obstet Gynecol 1988; 158:1239–40.

The Practice Committee of the American Society for Reproductive Medicine. Early diagnosis and management of ectopic pregnancy. Fertil Steril. 2004 Sep; 82 Suppl 1:S146-8.

Stovall TG, Ling FW, Cope BJ, Buster JE. Preventing ruptured ectopic pregnancy with a single serum progesterone. Am J Obstet Gynecol 1989;160:1425–8

Lipscomb GH. Medical therapy for ectopic pregnancy. Semin Reprod Med 2007; 25:93-8

Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynecol 2003; 101:778.

Starndell A, Thorburn J, Hamberger L. Risk factors for ectopic pregnancy in assisted reproduction. Fertl Steril. 1999, 71:282-6

Farquhar CM. Ectopic pregnancy. Lancet. 2005; 366:583-91

Hajenius PJ, Mol BWJ, Bossuyt PMM, Ankum WM, Van der Veen F. Interventions fortubal ectopic pregnancy. The Cochrane Database of Systematic Reviews 2000, Issue 1.Art. No.: CD000324. DOI: 10.1002/14651858.CD000324

Kirk E, Condous G, Bourne T. The non-surgical management of ectopic pregnancy. Ultrasound Obstet Gynecol. 2006; 27:91-100

Walker J. Guidelines on diagnosing ectopic pregnancy. 2002. The ectopic pregnancytrust. Disponible en: www.ectopic.org

Emery A, Buentipo B. Sonographic detection of cornual ectopic pregnancy. J Diagn Med Sonog 2008;24:252-256.

Diagnóstico y Tratamiento de Embarazo Tubario, México: Secretaría de Salud; 2009.

Stovall TG, Ling FW. Ectopic pregnancy: diagnostic and therapeutic algorithms minimizing surgical intervention. J Reprod Med 1993;38: 807-12.11.

Onderoglu LS, Salman MC, Ozyuncu O, Bozdag G. Successful management of a cornual pregnancy with a single high-dose laparoscopic methotrexate injection. Gynecol Surg 2006; 3: 31-33.

Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopicpregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. ObstetGynecol. 2003; 101:771-84

Published

2019-12-31

How to Cite

1.
Velasco Jácome S, Ramírez Romero J, Campoverde Ávila A, Cando Rendón M. Reporte de un caso: tratamiento farmacológico del Embarazo Ectópico: Report of a case: pharmacological treatment of Ectopic Pregnancy. lauinvestiga [Internet]. 2019 Dec. 31 [cited 2024 May 18];6(2):19-32. Available from: http://revistasojs.utn.edu.ec/index.php/lauinvestiga/article/view/432

Issue

Section

Original articles

Most read articles by the same author(s)

Similar Articles

<< < 1 2 3 

You may also start an advanced similarity search for this article.