2024-03-28T10:20:08Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00029348
2023-11-16T02:59:38Z
499:508:509:2478
Outcome of cesarean scar pregnancy treated with local methotrexate injection
Le, Minh Tam
Kotani, Tomomi
Tran, Manh Linh
Phan, Thi Minh Thu
Tran, Viet Khanh
Nguyen, Thi Kim Anh
Nguyen, Tran Thao Nguyen
Moriyama, Yoshinori
Yamamoto, Eiko
Nguyen, Vu Quoc Huy
Truong, Quang Vinh
Cao, Ngoc Thanh
Kikkawa, Fumitaka
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
gestational sac
human chorionic gonadotropin
transvaginal ultrasound
Local injection of methotrexate (MTX) has been widely used for caesarean scar pregnancy (CSP),but the optimal candidate remains undetermined. The aim of this study is to determine the risk factors associated with treatment failure among patients who received a single dose of local MTX. This is a retrospective cohort study. Clinical information was compared between treatment success vs. failure groups. Risk factors related to treatment failure were also investigated with multivariate analysis. Of 47 patients diagnosed with CSP, 30 received local MTX injection. The initial serum ß- human chorionic gonadotropin (hCG) level in the failure group was significantly higher than in the success group (p = 0.048), and the cut-off value was 47,000 mIU/ml. The rate of type 2 position of the gestational sac in the failure group was significantly higher than in the treatment success group (p = 0.031). A high initial serum ß-hCG level (≥ 47,000 mIU/ml) was identified as the independent risk factor for treatment failure (adjusted odds ratio = 21.9; 95% confidence interval = 1.3–383.1). Type 2 gestational sac position and a higher level of ß-hCG at diagnosis appear to be associated with poor outcomes after local injection of a single dose of MTX.
This work was supported by JSPS KAKENHI (Grant Number: 15H02660).
Nagoya University Graduate School of Medicine, School of Medicine
2020-02
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.82.1.15
http://hdl.handle.net/2237/00031535
https://nagoya.repo.nii.ac.jp/records/29348
10.18999/nagjms.82.1.15
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/821.html
2186-3326
0027-7622
Nagoya Journal of Medical Science
82
1
15
23
https://nagoya.repo.nii.ac.jp/record/29348/files/03_Tam.pdf
application/pdf
638.6 kB
2020-02-26