IMR Press / CEOG / Volume 51 / Issue 1 / DOI: 10.31083/j.ceog5101019
Open Access Original Research
Analysis of Clinical Effect and Influencing Factors for Conservative Treatment in Ectopic Pregnancy
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1 Department of Gynecology, Zigong Fourth People's Hospital, 643000 Zigong, Sichuan, China
2 Department of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, China
3 Department of Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230031 Hefei, Anhui, China
*Correspondence: 2390022692@qq.com (Cuiying Su); cjming@126.com (Jiming Chen)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2024, 51(1), 19; https://doi.org/10.31083/j.ceog5101019
Submitted: 12 August 2023 | Revised: 9 October 2023 | Accepted: 2 November 2023 | Published: 17 January 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: The curative effect of four different kinds of conservative treatment of ectopic pregnancy (EP) and the risk factors affecting the curative effect of conservative treatment of ectopic pregnancy were compared and analyzed. Methods: Retrospective analysis of the clinical data of patients with ectopic pregnancy treated conservatively in our hospital during the last 10 years. We compared and analyzed the clinical efficacy of four regimens: the expectant treatment, methotrexate (MTX), and methotrexate combined with mifepristone. Logistic regression was used to analyze the influencing factors of the curative effect for conservative treatment of ectopic pregnancy. Results: Initial serum of β human chorionic gonadotrophin (β-hCG) for the four groups of patients demonstrated statistically significant differences in β-hCG level and treatment success rate between groups (p < 0.05). When the serum β-hCG level was less than 1000 mIU/mL, the levels in the expected treatment group and mifepristone group were statistically significant (p = 0.002). There were no statistically significant differences in the treatment success rates between the four groups (p = 0.263). When the serum β-hCG level was 1000 mIU/mL, the treatment success rate of MTX combined with mifepristone group (9/15, 60%) was significantly higher than that of the other treatment groups (10/34, 29.4%). This difference was statistically significant (p = 0.045). When logistic regression analysis was performed, the initial serum β-hCG level (odds ratio (OR) = 0.999, 95% confidence interval (95% CI) 0.999–1) and abdominal pain score (OR = 0.4, 95% CI 0.267–0.6) were independent risk factors affecting the success of conservative treatment of ectopic pregnancy. Conclusions: Initial serum β-hCG level and abdominal pain score are the main risk factors affecting the success of conservative treatment of EP. When the serum β-hCG level was less than 1000 mIU/mL, there was no significant difference between the four conservative treatment regimens. When the serum β-hCG level was 1000 mIU/mL, the cure rate of MTX combined with mifepristone had obvious advantages over other regimens.

Keywords
ectopic pregnancy
conservative treatment
methotrexate
mifepristone
Funding
2021ZC27/Zigong Science and Technology Bureau Fund
2022CZBJ074/Top Talent of Changzhou “The 14th Five-Year Plan” High-Level Health Talents Training Project
RC202101/maternal and child health key talent project of Jiangsu Province
F202138/maternal and child health research project of Jiangsu Province
Figures
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