Inovative Surgical Treatment for Intratubal Administration of Methotrexate
Keywords:ectopic pregnancies, methotrexate, Human Chorionic Gonadotrophin Hormone.
AbstractIn patients where conservative medical treatment with methotrexate failed, surgical intervention was necessary. The personal surgical method was performed on a number of 9 patients; the surgical intervention was a conservative method – salpingorraphy. In order to prevent persistent gestational throphoblastic disease and tubal clogging, a polyethylene catheter is introduced in the oviduct until it reaches the ostium of the Fallopian tube, without exceeding it. In order to ensure a rigorous haemostasis, the Fallopian tube and the polyethylene catheter are sutured together. The level of HCG is measured in the fourth and seventh day postoperative: if the levels of HCG are higher than 1000 mUI/ml, if they plateau or if they have increased, methotrexate is administered intraluminally through the polyethylene tube, according to the following scheme: 50 mg of methotrexate are dissolved in 10 ml of physiological saline solution and injected through the polyethylene catheter, for 5 days. 10 mg per day in 2 doses (5 mg in the morning and 5 mg in the evening).If the values of HCG decrease to an adequate level and there is no risk of persistent throphoblastic disease, the polyethylene catheter is kept for 8-12 days, afterwards it is extracted by traction. If the values do not decrease accordingly, the intraluminal administration of methotrexate is resumed after a 3-day break. This method was used on a number of 9 patients; 4 of them had been treated with methotrexate before the surgical intervention and pertain to the study, and 5 of them had been operated on for complications of ectopic pregnancy and were suitable for this kind of surgical intervention. No postoperative complications or deaths were recorded.
How to Cite
Cezar Laurentiu, Rodica, & Tomescu, A. (2018). Inovative Surgical Treatment for Intratubal Administration of Methotrexate. European Journal of Medicine and Natural Sciences, 1(1), 7–12. https://doi.org/10.26417/ejis.v1i3.p53-58
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