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A cohort study to evaluate the effectiveness of laparoscopic-guided local injection of etoposide in the management of women with unruptured tubal pregnancy
Objective To assess the feasibility of laparoscopic-guided local injection of etoposide or methotrexate (MTX) in the management of unruptured tubal pregnancy and compare the effectiveness of the two regimens. Design Retrospective cohort study. Setting Medical center. Patient(s) Thirty-one women with...
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| Published in: | Fertility and sterility 2011-09, Vol.96 (3), p.654-658 |
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| container_title | Fertility and sterility |
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| creator | Chen, Ching-Hui, M.D Lee, Wen-Ling, M.D., Ph.D Chiu, Li-Hsuan, Ph.D Sun, Hsu-Dong, M.D Liu, Wei-Min, M.D Wang, Peng-Hui, M.D., Ph.D |
| description | Objective To assess the feasibility of laparoscopic-guided local injection of etoposide or methotrexate (MTX) in the management of unruptured tubal pregnancy and compare the effectiveness of the two regimens. Design Retrospective cohort study. Setting Medical center. Patient(s) Thirty-one women with laparoscopically diagnosed unruptured tubal pregnancy. Intervention(s) A regimen of etoposide 50 mg via laparoscopic-guided local injection (n = 17) compared with a conventional MTX 50 mg regimen (n = 11), after 3 patients were excluded (2 refusals and 1 with salpingostomy). Main Outcome Measure(s) Serial serum β-hCG levels and the success rate in both groups. Result(s) General characteristics of the patients were similar in both groups. The overall success rate was 96.4% (27 of 28). The duration between treatment and nadir of serum β-hCG level ( |
| doi_str_mv | 10.1016/j.fertnstert.2011.06.033 |
| format | article |
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Design Retrospective cohort study. Setting Medical center. Patient(s) Thirty-one women with laparoscopically diagnosed unruptured tubal pregnancy. Intervention(s) A regimen of etoposide 50 mg via laparoscopic-guided local injection (n = 17) compared with a conventional MTX 50 mg regimen (n = 11), after 3 patients were excluded (2 refusals and 1 with salpingostomy). Main Outcome Measure(s) Serial serum β-hCG levels and the success rate in both groups. Result(s) General characteristics of the patients were similar in both groups. The overall success rate was 96.4% (27 of 28). The duration between treatment and nadir of serum β-hCG level (<5 mIU/mL) was significantly shorter in the etoposide group than in the MTX group (19.7 ± 13.0 days vs. 33.4 ± 8.1 days). No patient in the etoposide group and only 1 in the MTX group needed reintervention, which led to 100% and 91% success rates for the etoposide and MTX groups, respectively. Three women in the etoposide group had subsequently successful term deliveries. Conclusion(s) Both regimens—etoposide 50 mg and MTX 50 mg via laparoscopic-guided local injection—were acceptable in the management of women with unruptured tubal pregnancy because of their similar and high success rates. More studies are needed to confirm this observation.</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2011.06.033</identifier><identifier>PMID: 21737074</identifier><identifier>CODEN: FESTAS</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abortifacient Agents, Nonsteroidal - administration & dosage ; Adult ; Antineoplastic Agents, Phytogenic - administration & dosage ; Biological and medical sciences ; blood serum ; Cohort Studies ; conservative treatment ; Digestive system. Abdomen ; Diseases of mother, fetus and pregnancy ; Endoscopy ; etoposide ; Etoposide - administration & dosage ; Fallopian Tubes - pathology ; Female ; Follow-Up Studies ; Gynecology. Andrology. Obstetrics ; Humans ; Injections - methods ; Internal Medicine ; Investigative techniques, diagnostic techniques (general aspects) ; laparoscopic-guided local injection ; Laparoscopy - methods ; Medical sciences ; methotrexate ; Methotrexate - administration & dosage ; Obstetrics and Gynecology ; patients ; Pregnancy ; Pregnancy, Tubal - drug therapy ; Pregnancy, Tubal - pathology ; Pregnancy. Fetus. Placenta ; Retrospective Studies ; Treatment Outcome ; women ; β-human chorionic gonadotropin</subject><ispartof>Fertility and sterility, 2011-09, Vol.96 (3), p.654-658</ispartof><rights>American Society for Reproductive Medicine</rights><rights>2011 American Society for Reproductive Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-448525bd0362374ea9cc81c9c405b77115fb0bc369324bce9e645c7968c9af523</citedby><cites>FETCH-LOGICAL-c482t-448525bd0362374ea9cc81c9c405b77115fb0bc369324bce9e645c7968c9af523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0015028211010107$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,786,790,3568,27957,27958,45815</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24533181$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21737074$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Ching-Hui, M.D</creatorcontrib><creatorcontrib>Lee, Wen-Ling, M.D., Ph.D</creatorcontrib><creatorcontrib>Chiu, Li-Hsuan, Ph.D</creatorcontrib><creatorcontrib>Sun, Hsu-Dong, M.D</creatorcontrib><creatorcontrib>Liu, Wei-Min, M.D</creatorcontrib><creatorcontrib>Wang, Peng-Hui, M.D., Ph.D</creatorcontrib><title>A cohort study to evaluate the effectiveness of laparoscopic-guided local injection of etoposide in the management of women with unruptured tubal pregnancy</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>Objective To assess the feasibility of laparoscopic-guided local injection of etoposide or methotrexate (MTX) in the management of unruptured tubal pregnancy and compare the effectiveness of the two regimens. Design Retrospective cohort study. Setting Medical center. Patient(s) Thirty-one women with laparoscopically diagnosed unruptured tubal pregnancy. Intervention(s) A regimen of etoposide 50 mg via laparoscopic-guided local injection (n = 17) compared with a conventional MTX 50 mg regimen (n = 11), after 3 patients were excluded (2 refusals and 1 with salpingostomy). Main Outcome Measure(s) Serial serum β-hCG levels and the success rate in both groups. Result(s) General characteristics of the patients were similar in both groups. The overall success rate was 96.4% (27 of 28). The duration between treatment and nadir of serum β-hCG level (<5 mIU/mL) was significantly shorter in the etoposide group than in the MTX group (19.7 ± 13.0 days vs. 33.4 ± 8.1 days). No patient in the etoposide group and only 1 in the MTX group needed reintervention, which led to 100% and 91% success rates for the etoposide and MTX groups, respectively. Three women in the etoposide group had subsequently successful term deliveries. Conclusion(s) Both regimens—etoposide 50 mg and MTX 50 mg via laparoscopic-guided local injection—were acceptable in the management of women with unruptured tubal pregnancy because of their similar and high success rates. More studies are needed to confirm this observation.</description><subject>Abortifacient Agents, Nonsteroidal - administration & dosage</subject><subject>Adult</subject><subject>Antineoplastic Agents, Phytogenic - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>blood serum</subject><subject>Cohort Studies</subject><subject>conservative treatment</subject><subject>Digestive system. Abdomen</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Endoscopy</subject><subject>etoposide</subject><subject>Etoposide - administration & dosage</subject><subject>Fallopian Tubes - pathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Injections - methods</subject><subject>Internal Medicine</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>laparoscopic-guided local injection</subject><subject>Laparoscopy - methods</subject><subject>Medical sciences</subject><subject>methotrexate</subject><subject>Methotrexate - administration & dosage</subject><subject>Obstetrics and Gynecology</subject><subject>patients</subject><subject>Pregnancy</subject><subject>Pregnancy, Tubal - drug therapy</subject><subject>Pregnancy, Tubal - pathology</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>women</subject><subject>β-human chorionic gonadotropin</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqNks2O0zAUhSMEYobCK4A3iFWKf-LE2SANI_6kkVgMs7Yc56Z1Se1gOx31WXhZbmhhJFbIkm3Z3z2-OsdFQRhdM8rqt7v1ADH7lHFec8rYmtZrKsSj4pJJWZeyluJxcUkpkyXlil8Uz1LaUUpr1vCnxQVnjWhoU10WP6-IDdsQM0l57o8kBwIHM84mA8lbIDAMYLM7gIeUSBjIaCYTQ7JhcrbczK6HnozBmpE4v1vQ4BcMcphCwls8_i20N95sYA8-L9f3AXfk3uUtmX2cpzxH1MlzhzpThI033h6fF08GMyZ4cV5Xxd3HD9-uP5c3Xz99ub66KW2leC6rSkkuu56KmoumAtNaq5htbUVl1zSMyaGjnRV1K3jVWWihrqRt2lrZ1gySi1Xx5qQ7xfBjhpT13iUL42g8hDlppRpJpULPVoU6kRYtSBEGPUW3N_GoGdVLMnqnH5LRSzKa1hqTwdKX50fmbg_938I_USDw-gyYhHYOES1w6YGrpBBMMeRenbjBBG02EZm7W3xJYtpcYZ9IvD8RgKYdHESdrANvoXcRE9J9cP_T77t_ROzovMPOvsMR0i7M0WMomunENdW3y19bvhpDWRyN-AWMUNMg</recordid><startdate>20110901</startdate><enddate>20110901</enddate><creator>Chen, Ching-Hui, M.D</creator><creator>Lee, Wen-Ling, M.D., Ph.D</creator><creator>Chiu, Li-Hsuan, Ph.D</creator><creator>Sun, Hsu-Dong, M.D</creator><creator>Liu, Wei-Min, M.D</creator><creator>Wang, Peng-Hui, M.D., Ph.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110901</creationdate><title>A cohort study to evaluate the effectiveness of laparoscopic-guided local injection of etoposide in the management of women with unruptured tubal pregnancy</title><author>Chen, Ching-Hui, M.D ; Lee, Wen-Ling, M.D., Ph.D ; Chiu, Li-Hsuan, Ph.D ; Sun, Hsu-Dong, M.D ; Liu, Wei-Min, M.D ; Wang, Peng-Hui, M.D., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-448525bd0362374ea9cc81c9c405b77115fb0bc369324bce9e645c7968c9af523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abortifacient Agents, Nonsteroidal - administration & dosage</topic><topic>Adult</topic><topic>Antineoplastic Agents, Phytogenic - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>blood serum</topic><topic>Cohort Studies</topic><topic>conservative treatment</topic><topic>Digestive system. Abdomen</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Endoscopy</topic><topic>etoposide</topic><topic>Etoposide - administration & dosage</topic><topic>Fallopian Tubes - pathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Injections - methods</topic><topic>Internal Medicine</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>laparoscopic-guided local injection</topic><topic>Laparoscopy - methods</topic><topic>Medical sciences</topic><topic>methotrexate</topic><topic>Methotrexate - administration & dosage</topic><topic>Obstetrics and Gynecology</topic><topic>patients</topic><topic>Pregnancy</topic><topic>Pregnancy, Tubal - drug therapy</topic><topic>Pregnancy, Tubal - pathology</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>women</topic><topic>β-human chorionic gonadotropin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Ching-Hui, M.D</creatorcontrib><creatorcontrib>Lee, Wen-Ling, M.D., Ph.D</creatorcontrib><creatorcontrib>Chiu, Li-Hsuan, Ph.D</creatorcontrib><creatorcontrib>Sun, Hsu-Dong, M.D</creatorcontrib><creatorcontrib>Liu, Wei-Min, M.D</creatorcontrib><creatorcontrib>Wang, Peng-Hui, M.D., Ph.D</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Ching-Hui, M.D</au><au>Lee, Wen-Ling, M.D., Ph.D</au><au>Chiu, Li-Hsuan, Ph.D</au><au>Sun, Hsu-Dong, M.D</au><au>Liu, Wei-Min, M.D</au><au>Wang, Peng-Hui, M.D., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A cohort study to evaluate the effectiveness of laparoscopic-guided local injection of etoposide in the management of women with unruptured tubal pregnancy</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2011-09-01</date><risdate>2011</risdate><volume>96</volume><issue>3</issue><spage>654</spage><epage>658</epage><pages>654-658</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><coden>FESTAS</coden><notes>http://dx.doi.org/10.1016/j.fertnstert.2011.06.033</notes><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Objective To assess the feasibility of laparoscopic-guided local injection of etoposide or methotrexate (MTX) in the management of unruptured tubal pregnancy and compare the effectiveness of the two regimens. Design Retrospective cohort study. Setting Medical center. Patient(s) Thirty-one women with laparoscopically diagnosed unruptured tubal pregnancy. Intervention(s) A regimen of etoposide 50 mg via laparoscopic-guided local injection (n = 17) compared with a conventional MTX 50 mg regimen (n = 11), after 3 patients were excluded (2 refusals and 1 with salpingostomy). Main Outcome Measure(s) Serial serum β-hCG levels and the success rate in both groups. Result(s) General characteristics of the patients were similar in both groups. The overall success rate was 96.4% (27 of 28). The duration between treatment and nadir of serum β-hCG level (<5 mIU/mL) was significantly shorter in the etoposide group than in the MTX group (19.7 ± 13.0 days vs. 33.4 ± 8.1 days). No patient in the etoposide group and only 1 in the MTX group needed reintervention, which led to 100% and 91% success rates for the etoposide and MTX groups, respectively. Three women in the etoposide group had subsequently successful term deliveries. Conclusion(s) Both regimens—etoposide 50 mg and MTX 50 mg via laparoscopic-guided local injection—were acceptable in the management of women with unruptured tubal pregnancy because of their similar and high success rates. More studies are needed to confirm this observation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21737074</pmid><doi>10.1016/j.fertnstert.2011.06.033</doi><tpages>5</tpages></addata></record> |
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| subjects | Abortifacient Agents, Nonsteroidal - administration & dosage Adult Antineoplastic Agents, Phytogenic - administration & dosage Biological and medical sciences blood serum Cohort Studies conservative treatment Digestive system. Abdomen Diseases of mother, fetus and pregnancy Endoscopy etoposide Etoposide - administration & dosage Fallopian Tubes - pathology Female Follow-Up Studies Gynecology. Andrology. Obstetrics Humans Injections - methods Internal Medicine Investigative techniques, diagnostic techniques (general aspects) laparoscopic-guided local injection Laparoscopy - methods Medical sciences methotrexate Methotrexate - administration & dosage Obstetrics and Gynecology patients Pregnancy Pregnancy, Tubal - drug therapy Pregnancy, Tubal - pathology Pregnancy. Fetus. Placenta Retrospective Studies Treatment Outcome women β-human chorionic gonadotropin |
| title | A cohort study to evaluate the effectiveness of laparoscopic-guided local injection of etoposide in the management of women with unruptured tubal pregnancy |
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