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Showing 2 results for Aflatoonian

Abbas Aflatoonian,
Volume 3, Issue 2 (Summer 2003)
Abstract

  Background & Objective : Even though the medical sciences have developed increasingly, ectopic pregnancy is still an important cause of maternal mortality. Despite many researches on medical therapy of ectopic pregnancy (EP), surgery is still the first management of patients with EP. Most of these patients have become pregnant for the first time and keeping their fertility in the future is very important. Surgery especially salpangectomy can do nothing to keep this fertility. It seems that efficacy of medical therapy of EP, especially in Iran is unknown. This research was conducted to determine the efficacy of medical therapy of EP with Methotrexate in some patients.

 Methods: In a prospective uncontrolled clinical trial study 26 patients with EP were hospitalized in Yazd Madar hospital. Six of them did not have any indications of medical therapy and were treated surgically.20 patients were treated with Methotrexate considering all the requirements. These patients received Methotrexate 1mg/kg daily. For the prevention of side effects, folinic acid with a dose of 0.1 Methotrexate was given. The efficacy of treatment was determined afterwards with the serial measuring of serum level. The data were analyzed using Chi-Square test and SPSS software.

 Results: The average age of these patients was 27.19 years and most of them had spotting as a symptom. They had been married for 6.9 years on average and most of these patients (42.3%) were experiencing their first pregnancy. Fourteen patients (53.8%) had a history of infertility and 26.9% had a history of abortion. 50% had experienced a previous abdominal surgery. Four patients had recurrent EP and the average of gestational age at the time of diagnosis was 6.2 weeks. Finally fifteen patients (75%) were treated successfully. Four out of five patients, who had a failed medical treatment, had a serum level higher than 1000 IU/L. Five out of eight patients, (62.5%) who were followed, experienced normal intrauterine pregnancy after one year of treatment.

 Conclusions: Medical therapy of Ectopic pregnancy with Methotrexate seems to be safe and effective but when serum level exceeds 1000 IU/L it is less likely to succeed.


Abbas Aflatoonian , Hajar Hojat , Nasim Tabibnejad,
Volume 4, Issue 4 (Winter 2004)
Abstract

Background & Objective: Ectopic pregnancy (EP) is the most common cause of maternal mortality in the first trimester. 10% of maternal death is due to EP and only one-third of women with previous ruptured ectopic pregnancy could have a normal delivery in future. Research about prevalence and risk factors of this kind of pregnancy, could help early diagnosis and treatment of EP and improve the prognosis of fertility rate in the future.

Methods: In this retrospective, descriptive and cross-sectional study, seventy-two patients with EP diagnosis admitted and treated in Yazd hospitals were studied. The data were collected using a questionnaire and hospital records. Sonography and laparoscopy confirmed the diagnosis. The data were analyzed by SPSS using Chi-Square test.

Results: 11176 pregnancies were recorded in Yazd between March 1999 and March 2000 and seventy-two of these pregnancies were ectopic. So prevalence of EC in yazd was found to be 0.5%. Most of the patients (58 cuses) were 20 to 39 years old. 52.8% of the patients had primipar. 25% had a history of one to three times abortion. From 43 patients who used contraceptive, 19 ones used OCP (oral contraceptive). 39 patients had a history of previous surgery, 7 patients had a history of EP and 25 patients had a history of treatment of infertility. The most common symptom of patients was abdominal pain. Only 4 out of 72 patients were treated with a medical method using methotraxe and the rest of them were operated. Three out of these four patients were finally obliged to undertake surgery.

Conclusion: The prevalence of EP was 0.5%, which is lower than the national scale. 

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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