Subsequent reproduction and obstetric outcome after methotrexate treatment of cervical pregnancy: a review of original literature and international collaborative follow-up |
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Authors: | Kung FT; Chang SY; Tsai YC; Hwang FR; Hsu TY; Soong YK |
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Institution: | Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. |
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Abstract: | The case reports of 22 patients with cervical pregnancies treated by
methotrexate (MTX) administration and published in English literature
between 1983 and 1995 were reviewed, by either original paper review or
follow-up under international collaboration, to determine the subsequent
reproductive performance and obstetric outcomes. Out of 22 cases, 18 (78%)
MTX chemotherapy attempts succeeded with complete remission and four (22%)
failed. Of the 13 women who wished to conceive and could be followed for at
least 3 years, nine succeeded in having live births without congenital
malformations, one spontaneously aborted and three suffered infertility. In
general, MTX chemotherapy alone or combined with adjuvant methods such as
subsequent cervical curettage or cervical tamponade, or intracervical
potassium chloride injection, appears to be a convenient and effective
method for the treatment of the majority of cervical pregnancies before 12
weeks gestation, and has not been shown to have detrimental effects on
subsequent reproductive capacities, obstetric outcomes and progeny health
for those cases with successful preservation of the uteri.
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