| Journal: | Revista da Associacao Medica Brasileira |
| Database: | PERIÓDICA |
| System number: | 000307413 |
| ISSN: | 0104-4230 |
| Authors: | Elito Junior, J1 Uchiyama, M Camano, L |
| Institutions: | 1Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo. Brasil |
| Year: | 1998 |
| Season: | Ene-Mar |
| Volumen: | 44 |
| Number: | 1 |
| Pages: | 11-15 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Experimental, analítico |
| English abstract | OBJECTIVE: The follow-up of this treatment is done by monitorization of beta-hCG titers. The objective of this study is to evaluate the beta-hCG titers after treatment with MTX. METHODS:. Twenty four women were included in the study. The inclusion criteria were: ectopic pregnancy < 4.5cm, beta-hCG < 15.000mIU/mL, desire of future pregnancy and a written permission to participate in the study. All patients were treated with a single dose of methotrexate (50mg/m² IM). Patients were monitored with beta-hCG titers on days 1, 4 and 7 after the MTX injection, and then weekly until the beta-hCG was less than 25mIU/mL. RESULTS: The variation of the titers of beta-hCG between day 1 and day 4 after MTX was the following: increase 50,0%, decrease 33.3% and in levels less than 25mUI/mL in 16.7% of the cases. The variation of the titers of beta-hCG between day 4 and day 7 after MTX was the following: decline > 15% in 85.7% of the cases, and decline < 15% in 14.3%. There was the necessity of a second dose of MTX in only two cases (8.4%), since the levels of beta-hCG declined less than 15%, in this period. CONCLUSION: The titers of beta-hCG increase in 50.0% of the cases, so it is a frequent event. The understanding of this evolution of beta-hCG titers avoids surgery in the first week of the treatment |
| Portuguese abstract | RESULTADOS: Doze (50,0%) dos 24 casos tiveram aumento dos títulos de beta-hCG nos primeiros quatro dias após a injecão IM de MTX, oito (33,3%) apresentaram queda paulatina dos valores e em quatro (16,7%) casos os valores de beta-hCG foram negativos no quarto dia pós-MTX. Apenas duas pacientes (8,3%) necessitaram de segunda dose de MTX por não ter havido queda dos títulos de beta-hCG superior a 15% entre o quarto e o sétimo dia. CONCLUSÕES: A elevação dos títulos de beta-hCG, entre o momento da ministração do MTX e o quarto dia após a medicação, foi evento freqüente (50,0%). A queda de mais de 15% dos valores de beta-hCG, apurada no quarto e no sétimo dia pós-MTX, constitui parâmetro importante para o critério de alta hospitalar. Por outro lado, redução menor que 15% dos níveis séricos de beta-hCG representa indicação para ministração de nova dose de MTX. Em apenas duas pacientes (8,4%) houve necessidade de segunda dose de MTX, pois os títulos de beta-hCG, avaliados no quarto e no sétimo dia após o MTX, apresentaram queda, porém, inferior a 15% |
| Disciplines: | Medicina |
| Keyword: | Ginecología y obstetricia, Embarazo, Embarazo ectópico, Beta-hCG, Metotrexato, Tratamiento |
| Keyword: | Medicine, Gynecology and obstetrics, Pregnancy, Ectopic pregnancy, Beta-hCG, Methotrexate, Treatment |
| Full text: | Texto completo (Ver HTML) |
