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| Intratubal methotrexate injection combined with Chinese herbal medicine for tubal pregnancy and following pregnancy prognosis |
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| KeyWord:methotrexate, tubal pregnancy, traditional Chinese medicine |
| Author Name | Affiliation | E-mail | | Wang Yu-dong | Department of Obstetrics &
Gynecology, Hospital affiliated to Shandong University of Traditional Chinese Medicine, 250014, Ji’nan | owangyudong@hotmail.com | | Li Da-Jin | Laboratory of Reproductive Immunology, Institute of Obstetrics &
Gynecology, Fudan University, 200011, Shanghai | | | Lian Fang | Department of Obstetrics &
Gynecology, Hospital affiliated to Shandong University of Traditional Chinese Medicine, 250014, Ji’nan | | | Zhang Jian-wei | Department of Obstetrics &
Gynecology, Hospital affiliated to Shandong University of Traditional Chinese Medicine, 250014, Ji’nan | |
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| Abstract: |
| Objective: To compare the effects of treatment of tubal pregnancy (TP)and its following second pregnancy by intratubal methotrexate injection (IMI) alone and combination of IMI with Chinese herbal medicine.Methods: Thirty-five patients suffering from unruptured TP were divided into two groups at random, to the 19 patients in the treated group, the treatment of combined IMI with Ectopic Pregnancy decoction No. 2 (EP2, a traditional Chinese medical decoction) was applied, and to the other 16 patients in the control group, IMI alone was applied for control. Serum concentrations of human chorionic gonadotropin β (β-HCG), size of the gestational sac, existent time of fetal cardiac beat and peritoneal fluid were measured before and after treatment. And hysterosalpingography were performed 6 months after ending the treatment to verify the presence of tubal obstruction and the condition of relapse.Results: The treatment of all the 35 women was successful. The recovery duration of serum β-HCG, disappearance duration of TP sac and existent time of peritoneal fluid in the treated group were 20.0±7.8 days, 1.2±0.7 months and 10.7±2.9 days respectively, which were significantly different from those in the control group (24. 4 ±8.1 days, 3.6±1.7 months and 19.1±3. 2 days respectively(P<0.05, P<0.01 and P<0.05 respectively), but the existent time of fetal cardiac beat in the two groups (8.8±1.9 days vs 9.0±l. 3 days) was not significantly different (P>0.05). The post-treatment oviduct obstructive rate in the two groups was 10.5% and 43.8% respectively, that in the treatment group was less significant (P<0.05). The relapse rate of EP in the treatment group was insignificantly different from that in the control group (5.3% vs 18.8%, P>0.05).Conclusion: The two therapies (IMI alone and IMI combined with EP2) could obtain equal efficacy in curing TP. Compared with IMI alone, the combined therapy appears to have the effects of accelerating the resorption of gestational sac and peritoneal fluid, improving the patency of fallopian tube and ameliorating the circumstance of pregnancy, which is favorable to improvement of the re-pregnancy rate and reduction of the re-occurrence of ectopic pregnancy as well as to the enhancement of the effect of IMI in killing trophocytes. But there is not enough proof to show the potency of EP2 in killing embryo. |
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