MỐI LIÊN QUAN GIỮA ĐỘ DÀY NỘI MẠC TỬ CUNG TRÊN 12MM VỚI THẤT BẠI ĐIỀU TRỊ PHÁC ĐỒ METHOTREXATE ĐƠN LIỀU Ở THAI ỐNG DẪN TRỨNG TẠI BỆNH VIỆN HÙNG VƯƠNG

Abstract

Background: Medical treatment with Methotrexate for management of ectopic pregnancy – has been applied effectively and commonly in clinical practice. Severals studies investigated the predictive factors of medical treatment outcome in ectopic pregnancy. Endometrial thickness was found to be associated with the risk of single-dose MTX failure. Objectives: to compare the treatment outcomes of single-dose MTX therapy for tubal ectopic pregnancy between two groups: patients who had endometrial stripe thickness >12mm (group 1) and patients with endometrial stripe thickness ≤12mm (group 2). Methods: A retrospective cohort study comprised two hundred and seventy patients who were hospitalized with a diagnosis of tubal ectopic pregnancy and treated with single-dose Methotrexate. These candidates were divided into two equally sized groups based on endometrial thickness through transvaginal ultrasound (>12mm or ≤12mm). Results: The failure rate in the group with endometrial stripe thickness >12mm was 1,85 times higher than that in the group ≤12mm (27,4% vs. 14,8%, respectively; with p=0,027). Participants with endometrial thickness >12mm were statistically associated with greater duration of hospitalization and slower decrease in serum βhCG level between day 1-7, compared to the other group. There was no significant difference in the total of MTX injections, time to resolution as well as surgical characteristics among unsuccessfull cases between the two studying groups. Conclusion: Endometrial stripe thicker than 12mm increases treatment failure of single-dose Methotrexate therapy for management of tubal ectopic pregnancy.