Retrospective review of the medical management of ectopic pregnancies with methotrexate at a South African tertiary hospital
| dc.contributor.author | De Waard, L. | en_ZA |
| dc.contributor.author | Butt, J. L. | en_ZA |
| dc.contributor.author | Muller, C. J. B. | en_ZA |
| dc.contributor.author | Cluver, C. A. | en_ZA |
| dc.date.accessioned | 2017-02-14T12:38:41Z | |
| dc.date.available | 2017-02-14T12:38:41Z | |
| dc.date.issued | 2014 | |
| dc.description | CITATION: De Waard, L., et al. 2014. Retrospective review of the medical management of ectopic pregnancies with methotrexate at a South African tertiary hospital. South African Journal of Obstetrics and Gynaecology, 20(3):84-87, doi:10.7196/SAJOG.920. | |
| dc.description | The original publication is available at http://www.sajog.org.za | |
| dc.description.abstract | Background. An ectopic pregnancy can be a life-threatening condition. Early diagnosis with ultrasonography and quantitative betahuman chorionic gonadotrophin (β-hCG) measurement has improved early and accurate diagnosis and treatment. Medical management with methotrexate internationally has a success rate of up to 93%, but there is a paucity of data on this treatment option in developing countries. Objective. To determine the success of methotrexate treatment for ectopic pregnancies at a referral hospital in a developing country. This non-surgical, outpatient treatment seems a good option in hospitals with an ever-rising pressure on bed occupation and long waiting lists for emergency surgery. Methods. A 5-year retrospective audit was performed on 124 patients treated for ectopic pregnancies with methotrexate at Tygerberg Hospital, Cape Town, South Africa. Results. With success defined as a β-hCG level of <15 IU/L without requiring surgical intervention, the success rate was 44%. Fifteen per cent of medically managed patients required surgery. The remaining 41% were lost to follow-up. One patient had a major adverse outcome with a ruptured ectopic and required 2 units of blood, resuscitation and emergency laparotomy. Conclusion. Medical management of ectopic pregnancies is a safe and effective management option, as proven by international data, but at Tygerberg Hospital the safety of this treatment modality cannot be guaranteed because of poor follow-up. Improvement in patient selection with consideration of predictors of success and thorough counselling, as well as full informed consent, is recommended before using this treatment modality. A new follow-up system should be developed at Tygerberg Hospital to guarantee patient safety. | en_ZA |
| dc.description.uri | http://www.sajog.org.za/index.php/SAJOG/article/view/920/474 | |
| dc.description.version | Publisher's version | |
| dc.format.extent | 4 pages | en_ZA |
| dc.identifier.citation | De Waard, L., et al. 2014. Retrospective review of the medical management of ectopic pregnancies with methotrexate at a South African tertiary hospital. South African Journal of Obstetrics and Gynaecology, 20(3):84-87, doi:10.7196/SAJOG.920 | |
| dc.identifier.issn | 2305-8862 (online) | |
| dc.identifier.issn | 0038-2329 (print) | |
| dc.identifier.other | doi:10.7196/SAJOG.920 | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/100629 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Health and Medical Publishing Group | |
| dc.rights.holder | Author retains copyright | |
| dc.subject | Ectopic pregnancy | en_ZA |
| dc.subject | Abdominal pregnancy -- Treatment | en_ZA |
| dc.subject | Methotrexate | en_ZA |
| dc.title | Retrospective review of the medical management of ectopic pregnancies with methotrexate at a South African tertiary hospital | en_ZA |
| dc.type | Article | en_ZA |