비파열성 난관임신에 대한 Methotrexate의 비수술적 치료

Abstract

Nonsurgical management of the unruptured tubal pregnancy with methotrexate is suggessted as an alternative to surgery in the management of early unruptured tubal pregnancy. Entry criteria required that the ectopic focus be tubal pregnanpy, no greater than 18 mm in diameter by USG, no active bleeding and no abnormal fluid collection in Cul de sac. The diagnosis was established in all three cases by sonography, serum beta-subunit of human chorionic gonadotropin. Three unreptured tubal pregnancies were treated with four doses methotrexate (1.0 mg/kg/day) followed by four doses of citrovorum fator(0.1 mg/kg/day). The treatment was based upon the level of beta-hCG, size of gestational sac on follow up USG, improvement of clinical symptoms with MTX/CF given to subjects. In all three subjects, the ectopic pregnancies were resoluted without further surgical intervention. Our experience suggests that the nonsurgical conservative management of the methotrexate may become a new, effective & safe treatment modality for the unruptured tubal pregnancy.