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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 72 No. 3, 2018.

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METHOTREXATE THERAPY IN GYNECOLOGIC PATIENTS: FOUR-YEAR EXPERIENCE AT A TERTIARY REFERRAL CENTER

PAVO PERKOVIĆ ; Merkur University Hospital, Department of Gynecology and Obstetrics, Zagreb, Croatia
KATJA VINCE orcid id orcid.org/0000-0001-5992-5030 ; Merkur University Hospital, Department of Gynecology and Obstetrics, Zagreb, Croatia
RATKO MATIJEVIĆ orcid id orcid.org/0000-0003-1693-7474 ; Merkur University Hospital, Department of Gynecology and Obstetrics and University of Zagreb, School of Medicine, Department of Gynecology and Obstetrics, Zagreb, Croatia

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Abstract

Aim: The aim of this study was to present methotrexate treatment results in ectopic pregnancy and gestational trophoblastic neoplasia (GTN) at a tertiary referral center. Methods: A retrospective case-series study was conducted using data from records of patients treated with methotrexate during a 4-year period at Merkur University Hospital in Zagreb, Croatia. The study included 11 patients divided into 2 groups: 6 patients with ectopic pregnancy (5 tubal and 1 cornual) and 5 patients
with low-risk GTN. Patients with ectopic pregnancy were treated with single dose methotrexate protocol (1 mg/kg/day intramuscularly), whereas those with low-risk GTN were treated with 8-day single-agent methotrexate along with leucovorin rescue protocol. Results: Among 5 tubal pregnancies, methotrexate treatment was successful in 4 (80%) cases, while one patient required surgical treatment. One case of cornual pregnancy also required surgical treatment after ineffective methotrexate treatment. Of 5 GTN cases treated with methotrexate, 3 required further EMA-CO treatment and 1 required additional surgical treatment, yielding the overall success rate of methotrexate treatment of 20%. Conclusion: Methotrexate is a valuable medication for treatment of appropriately selected ectopic pregnancy cases, while its usefulness and effi ciency in the treatment of low-risk GTN diseases has not been confi rmed.

Keywords

methotrexate; ectopic pregnancy; gestational trophoblastic disease; gestational trophoblastic neoplasia; invasive mole; choriocarcinoma

Hrčak ID:

208528

URI

https://hrcak.srce.hr/208528

Publication date:

16.11.2018.

Article data in other languages: croatian

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