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Консервативная тактика ведения пациенток с внематочной беременностью
Консервативная тактика ведения пациенток с внематочной беременностью
Доброхотова Ю.Э., Белоусова Т.Н., Боровкова Е.И., Соваев Н.И., Егорушкина В.Д., Кладницкая А.Д., Ермакова А. Консервативная тактика ведения пациенток с внематочной беременностью. Гинекология. 2023;25(4):435–441. DOI: 10.26442/20795696.2023.4.202518
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
DOI: 10.26442/20795696.2023.4.202518
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
________________________________________________
DOI: 10.26442/20795696.2023.4.202518
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Аннотация
Внематочная беременность является состоянием, требующим оказания неотложной медицинской помощи. В настоящее время хирургическое лечение является основным методом терапии, а консервативное лечение с применением метотрексата рассматривается в качестве допустимой альтернативы. Метотрексат является антагонистом фолиевой кислоты и оказывает ингибирующее действие на пролиферацию клеток трофобласта. Существуют различные протоколы применения метотрексата, выбор которых определяется уровнем β-субъединицы хорионического гонадотропина человека, локализацией внематочной беременности и приверженностью пациентки лечению. Терапия внематочной трубной беременности метотрексатом является эффективной и безопасной альтернативой хирургическому лечению, не оказывает влияния на показатели овариального резерва и сохраняет возможность женщины реализовать ее репродуктивную функцию.
Ключевые слова: внематочная трубная беременность, метотрексат, сальпингэктомия, сальпингостомия, Лейковорин, трофобласт, овариальный резерв
Keywords: ectopic tubal pregnancy, methotrexate, salpingectomy, salpingostomy, leucovorin, trophoblast, ovarian reserve
Ключевые слова: внематочная трубная беременность, метотрексат, сальпингэктомия, сальпингостомия, Лейковорин, трофобласт, овариальный резерв
________________________________________________
Keywords: ectopic tubal pregnancy, methotrexate, salpingectomy, salpingostomy, leucovorin, trophoblast, ovarian reserve
Полный текст
Список литературы
1. Zane SB, Kieke BA Jr, Kendrick JS, Bruce C. Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. Matern Child Health J. 2002;6:227.
2. Справочник Министерства здравоохранения Российской Федерации. M., 2019; c. 30 [Spravochnik Ministerstva zdravookhraneniia Rossiiskoi Federatsii. Moscow, 2019; p. 30 (in Russian)].
3. Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol. 2005;105:1052.
4. Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol. 2010;115:495.
5. Stulberg DB, Cain LR, Dahlquist I, Lauderdale DS. Ectopic pregnancy rates and racial disparities in the Medicaid population. 2004–2008. Fertil Steril. 2014;102:1671.
6. Mann LM, Kreisel K, Llata E, et al. Trends in Ectopic Pregnancy Diagnoses in United States Emergency Departments. 2006–2013. Matern Child Health J. 2020;24:213.
7. Stulberg DB, Cain L, Dahlquist IH, Lauderdale DS. Ectopic pregnancy morbidity and mortality in low-income women. 2004–2008. Hum Reprod. 2016;31:666.
8. Creanga AA, Shapiro-Mendoza CK, Bish CL, et al. Trends in ectopic pregnancy mortality in the United States: 1980–2007. Obstet Gynecol. 2011;117:837.
9. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111:1479.
10. Practice Committee of American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013;100:638.
11. Willner N, Storch S, Tadmor T, Schiff E. Almost a tragedy: severe methotrexate toxicity in a hemodialysis patient treated for ectopic pregnancy. Eur J Clin Pharmacol. 2014;70:261.
12. Menon S, Colins J, Barnhart KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril. 2007;87:481.
13. Lipscomb GH, McCord ML, Stovall TG, et al. Predictors of success of methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med. 1999;341:1974.
14. Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing "single dose" and "multidose" regimens. Obstet Gynecol. 2003;101:778.
15. Nazac A, Gervaise A, Bouyer J, et al. Predictors of success in methotrexate treatment of women with unruptured tubal pregnancies. Ultrasound Obstet Gynecol. 2003;21:181.
16. Gamzu R, Almog B, Levin Y, et al. The ultrasonographic appearance of tubal pregnancy in patients treated with methotrexate. Hum Reprod. 2002;17:2585.
17. Vermesh M, Graczykowski JW, Sauer MV. Reevaluation of the role of culdocentesis in the management of ectopic pregnancy. Am J Obstet Gynecol. 1990;162:411.
18. Bixby S, Tello R, Kuligowska E. Presence of a yolk sac on transvaginal sonography is the most reliable predictor of single-dose methotrexate treatment failure in ectopic pregnancy. J Ultrasound Med. 2005;24:591.
19. Potter MB, Lepine LA, Jamieson DJ. Predictors of success with methotrexate treatment of tubal ectopic pregnancy at Grady Memorial Hospital. Am J Obstet Gynecol. 2003;188:1192.
20. Dudley PS, Heard MJ, Sangi-Haghpeykar H, et al. Characterizing ectopic pregnancies that rupture despite treatment with methotrexate. Fertil Steril. 2004;82:137.
21. Takacs P, Rodriguez L. High folic acid levels and failure of single-dose methotrexate treatment in ectopic pregnancy. Int J Gynaecol Obstet. 2005;89:301.
22. Levine Y, Yahav L, Schwarzman P, et al. The correlation between endometrial thickness and the criteria for MTX treatment for ectopic pregnancy. J Obstet Gynaecol. 2021;41:1230.
23. Fang T, Chen M, Yu W, et al. The predictive value of endometrial thickness in 3117 fresh IVF/ICSI cycles for ectopic pregnancy. J Gynecol Obstet Hum Reprod. 2021;50:102072.
24. Hoyos LR, Malik M, Najjar M, et al. Morbid obesity and outcome of ectopic pregnancy following capped single-dose regimen methotrexate. Arch Gynecol Obstet. 2017;295:375.
25. Levin G, Meyer R, Dior U, et al. Outcome of methotrexate treatment for ectopic pregnancies among obese women. J Gynecol Obstet Hum Reprod. 2020;101790.
26. Mol F, Mol BW, Ankum WM, et al. Current evidence on surgery, systemic methotrexate and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod Update. 2008;14:309.
27. Morlock RJ, Lafata JE, Eisenstein D. Cost-effectiveness of single-dose methotrexate compared with laparoscopic treatment of ectopic pregnancy. Obstet Gynecol. 2000;95:407.
28. Nieuwkerk PT, Hajenius PJ, Ankum WM, et al. Systemic methotrexate therapy versus laparoscopic salpingostomy in patients with tubal pregnancy. Part I. Impact on patients' health-related quality of life. Fertil Steril. 1998;70:511.
29. Grimes DA. Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999. Am J Obstet Gynecol. 2006;194:92.
30. Oriol B, Barrio A, Pacheco A, et al. Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve. Fertil Steril. 2008;90:1579.
31. Wiser A, Gilbert A, Nahum R, et al. Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle. Reprod Biomed Online. 2013;26:449.
32. Gay C, Perrin J, Courbiere B, et al. Impact of salpingectomy for ectopic pregnancy on the ovarian response during IVF stimulation. J Gynecol Obstet Hum Reprod. 2019;48:727.
33. Ohannessian A, Loundou A, Courbière B, et al. Ovarian responsiveness in women receiving fertility treatment after methotrexate for ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod. 2014;29:1949.
34. Strauss JF, Williams CJ. The ovarian life cycle. In: Yen and Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management, 5th ed., Strauss JF, Barbieri RL (Eds.), Elsevier Saunders, Philadelphia, 2004; p. 213.
35. Svirsky R, Rozovski U, Vaknin Z, et al. The safety of conception occurring shortly after methotrexate treatment of an ectopic pregnancy. Reprod Toxicol. 2009;27:85.
36. Chouinard M, Mayrand MH, Ayoub A, et al. Ectopic pregnancy and outcomes of future intrauterine pregnancy. Fertil Steril. 2019;112:112.
37. Lipscomb GH, Givens VM, Meyer NL, Bran D. Comparison of multidose and single-dose methotrexate protocols for the treatment of ectopic pregnancy. Am J Obstet Gynecol. 2005;192:1844.
38. Hajenius PJ, Mol F, Mol BW, et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;CD000324.
39. Alur-Gupta S, Cooney LG, Senapati S, et al. Two-dose versus single-dose methotrexate for treatment of ectopic pregnancy: a meta-analysis. Am J Obstet Gynecol. 2019;221:95.
40. Jermy K, Thomas J, Doo A, Bourne T. The conservative management of interstitial pregnancy. BJOG. 2004;111:1283.
41. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins – Gynecology. ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy. Obstet Gynecol. 2018;131:e91.
42. Stovall TG, Ling FW. Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol. 1993;168:1759.
43. Natale A, Candiani M, Barbieri M, et al. Pre- and post-treatment patterns of human chorionic gonadotropin for early detection of persistence after a single dose of methotrexate for ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol. 2004;117:87.
44. Saraj AJ, Wilcox JG, Najmabadi S, et al. Resolution of hormonal markers of ectopic gestation: a randomized trial comparing single-dose intramuscular methotrexate with salpingostomy. Obstet Gynecol. 1998;92:989.
45. Tang A, Baartz D, Khoo SK. A medical management of interstitial ectopic pregnancy: a 5-year clinical study. Aust N Z J Obstet Gynaecol. 2006;46:107.
46. Xiao C, Shi Q, Cheng Q, Xu J. Non-surgical management of tubal ectopic pregnancy: A systematic review and meta-analysis. Medicine (Baltimore). 2021;100:e27851.
47. Nilsson UW, Johns TG, Wilmann T, et al. Effects of gefitinib, an epidermal growth factor receptor inhibitor, on human placental cell growth. Obstet Gynecol. 2013;122:737.
48. Skubisz MM, Horne AW, Johns TG, et al. Combination gefitinib and methotrexate compared with methotrexate alone to treat ectopic pregnancy. Obstet Gynecol. 2013; 122:745.
49. Korhonen J, Stenman UH, Ylöstalo P. Low-dose oral methotrexate with expectant management of ectopic pregnancy. Obstet Gynecol. 1996;88:775.
50. Webster K, Eadon H, Fishburn S, et al. Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance. BMJ. 2019;367:l6283.
51. Ectopic pregnancy and miscarriage: diagnosis and initial management. NICE guideline [NG126]. National Institute for Health Care Excellence. April. 2019. Available at: https://www.nice.org.uk/guidance/ng126/chapter/Recommendations#management-of-miscarriage. Accessed: 03.03.2021.
52. Bachman EA, Barnhart K. Medical management of ectopic pregnancy: a comparison of regimens. Clin Obstet Gynecol. 2012;55:440.
53. van Mello NM, Mol F, Verhoeve HR, et al. Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomized comparison. Hum Reprod. 2013;28:60.
54. Jurkovic D, Memtsa M, Sawyer E, et al. Single-dose systemic methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo-controlled randomized trial. Ultrasound Obstet Gynecol. 2017;49:171.
55. van Mello NM, Mol F, Adriaanse AH, et al. The METEX study: methotrexate versus expectant management in women with ectopic pregnancy: a randomised controlled trial. BMC Womens Health. 2008;8:10.
56. Silva PM, Araujo Júnior E, Cecchino GN, et al. Effectiveness of expectant management versus methotrexate in tubal ectopic pregnancy: a double-blind randomized trial. Arch Gynecol Obstet. 2015;291:939.
57. van Mello NM, Mol F, Hajenius PJ, et al. Randomized comparison of health-related quality of life in women with ectopic pregnancy or pregnancy of unknown location treated with systemic methotrexate or expectant management. Eur J Obstet Gynecol Reprod Biol. 2015;192:1.
58. Craig LB, Khan S. Expectant management of ectopic pregnancy. Clin Obstet Gynecol. 2012;55:461.
59. Dooley W, De Braud L, Memtsa M, et al. Physical resolution of tubal ectopic pregnancy on ultrasound imaging following successful expectant management. Reprod Biomed Online. 2020;40:880.
60. Strobelt N, Mariani E, Ferrari L, et al. Fertility after ectopic pregnancy. Effects of surgery and expectant management. J Reprod Med. 2000;45:803.
61. Helmy S, Sawyer E, Ofili-Yebovi D, et al. Fertility outcomes following expectant management of tubal ectopic pregnancy. Ultrasound Obstet Gynecol. 2007;30:988.
2. Spravochnik Ministerstva zdravookhraneniia Rossiiskoi Federatsii. Moscow, 2019; p. 30 (in Russian).
3. Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol. 2005;105:1052.
4. Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol. 2010;115:495.
5. Stulberg DB, Cain LR, Dahlquist I, Lauderdale DS. Ectopic pregnancy rates and racial disparities in the Medicaid population. 2004–2008. Fertil Steril. 2014;102:1671.
6. Mann LM, Kreisel K, Llata E, et al. Trends in Ectopic Pregnancy Diagnoses in United States Emergency Departments. 2006–2013. Matern Child Health J. 2020;24:213.
7. Stulberg DB, Cain L, Dahlquist IH, Lauderdale DS. Ectopic pregnancy morbidity and mortality in low-income women. 2004–2008. Hum Reprod. 2016;31:666.
8. Creanga AA, Shapiro-Mendoza CK, Bish CL, et al. Trends in ectopic pregnancy mortality in the United States: 1980–2007. Obstet Gynecol. 2011;117:837.
9. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111:1479.
10. Practice Committee of American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013;100:638.
11. Willner N, Storch S, Tadmor T, Schiff E. Almost a tragedy: severe methotrexate toxicity in a hemodialysis patient treated for ectopic pregnancy. Eur J Clin Pharmacol. 2014;70:261.
12. Menon S, Colins J, Barnhart KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril. 2007;87:481.
13. Lipscomb GH, McCord ML, Stovall TG, et al. Predictors of success of methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med. 1999;341:1974.
14. Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing "single dose" and "multidose" regimens. Obstet Gynecol. 2003;101:778.
15. Nazac A, Gervaise A, Bouyer J, et al. Predictors of success in methotrexate treatment of women with unruptured tubal pregnancies. Ultrasound Obstet Gynecol. 2003;21:181.
16. Gamzu R, Almog B, Levin Y, et al. The ultrasonographic appearance of tubal pregnancy in patients treated with methotrexate. Hum Reprod. 2002;17:2585.
17. Vermesh M, Graczykowski JW, Sauer MV. Reevaluation of the role of culdocentesis in the management of ectopic pregnancy. Am J Obstet Gynecol. 1990;162:411.
18. Bixby S, Tello R, Kuligowska E. Presence of a yolk sac on transvaginal sonography is the most reliable predictor of single-dose methotrexate treatment failure in ectopic pregnancy. J Ultrasound Med. 2005;24:591.
19. Potter MB, Lepine LA, Jamieson DJ. Predictors of success with methotrexate treatment of tubal ectopic pregnancy at Grady Memorial Hospital. Am J Obstet Gynecol. 2003;188:1192.
20. Dudley PS, Heard MJ, Sangi-Haghpeykar H, et al. Characterizing ectopic pregnancies that rupture despite treatment with methotrexate. Fertil Steril. 2004;82:137.
21. Takacs P, Rodriguez L. High folic acid levels and failure of single-dose methotrexate treatment in ectopic pregnancy. Int J Gynaecol Obstet. 2005;89:301.
22. Levine Y, Yahav L, Schwarzman P, et al. The correlation between endometrial thickness and the criteria for MTX treatment for ectopic pregnancy. J Obstet Gynaecol. 2021;41:1230.
23. Fang T, Chen M, Yu W, et al. The predictive value of endometrial thickness in 3117 fresh IVF/ICSI cycles for ectopic pregnancy. J Gynecol Obstet Hum Reprod. 2021;50:102072.
24. Hoyos LR, Malik M, Najjar M, et al. Morbid obesity and outcome of ectopic pregnancy following capped single-dose regimen methotrexate. Arch Gynecol Obstet. 2017;295:375.
25. Levin G, Meyer R, Dior U, et al. Outcome of methotrexate treatment for ectopic pregnancies among obese women. J Gynecol Obstet Hum Reprod. 2020;101790.
26. Mol F, Mol BW, Ankum WM, et al. Current evidence on surgery, systemic methotrexate and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod Update. 2008;14:309.
27. Morlock RJ, Lafata JE, Eisenstein D. Cost-effectiveness of single-dose methotrexate compared with laparoscopic treatment of ectopic pregnancy. Obstet Gynecol. 2000;95:407.
28. Nieuwkerk PT, Hajenius PJ, Ankum WM, et al. Systemic methotrexate therapy versus laparoscopic salpingostomy in patients with tubal pregnancy. Part I. Impact on patients' health-related quality of life. Fertil Steril. 1998;70:511.
29. Grimes DA. Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999. Am J Obstet Gynecol. 2006;194:92.
30. Oriol B, Barrio A, Pacheco A, et al. Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve. Fertil Steril. 2008;90:1579.
31. Wiser A, Gilbert A, Nahum R, et al. Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle. Reprod Biomed Online. 2013;26:449.
32. Gay C, Perrin J, Courbiere B, et al. Impact of salpingectomy for ectopic pregnancy on the ovarian response during IVF stimulation. J Gynecol Obstet Hum Reprod. 2019;48:727.
33. Ohannessian A, Loundou A, Courbière B, et al. Ovarian responsiveness in women receiving fertility treatment after methotrexate for ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod. 2014;29:1949.
34. Strauss JF, Williams CJ. The ovarian life cycle. In: Yen and Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management, 5th ed., Strauss JF, Barbieri RL (Eds.), Elsevier Saunders, Philadelphia, 2004; p. 213.
35. Svirsky R, Rozovski U, Vaknin Z, et al. The safety of conception occurring shortly after methotrexate treatment of an ectopic pregnancy. Reprod Toxicol. 2009;27:85.
36. Chouinard M, Mayrand MH, Ayoub A, et al. Ectopic pregnancy and outcomes of future intrauterine pregnancy. Fertil Steril. 2019;112:112.
37. Lipscomb GH, Givens VM, Meyer NL, Bran D. Comparison of multidose and single-dose methotrexate protocols for the treatment of ectopic pregnancy. Am J Obstet Gynecol. 2005;192:1844.
38. Hajenius PJ, Mol F, Mol BW, et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;CD000324.
39. Alur-Gupta S, Cooney LG, Senapati S, et al. Two-dose versus single-dose methotrexate for treatment of ectopic pregnancy: a meta-analysis. Am J Obstet Gynecol. 2019;221:95.
40. Jermy K, Thomas J, Doo A, Bourne T. The conservative management of interstitial pregnancy. BJOG. 2004;111:1283.
41. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins – Gynecology. ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy. Obstet Gynecol. 2018;131:e91.
42. Stovall TG, Ling FW. Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol. 1993;168:1759.
43. Natale A, Candiani M, Barbieri M, et al. Pre- and post-treatment patterns of human chorionic gonadotropin for early detection of persistence after a single dose of methotrexate for ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol. 2004;117:87.
44. Saraj AJ, Wilcox JG, Najmabadi S, et al. Resolution of hormonal markers of ectopic gestation: a randomized trial comparing single-dose intramuscular methotrexate with salpingostomy. Obstet Gynecol. 1998;92:989.
45. Tang A, Baartz D, Khoo SK. A medical management of interstitial ectopic pregnancy: a 5-year clinical study. Aust N Z J Obstet Gynaecol. 2006;46:107.
46. Xiao C, Shi Q, Cheng Q, Xu J. Non-surgical management of tubal ectopic pregnancy: A systematic review and meta-analysis. Medicine (Baltimore). 2021;100:e27851.
47. Nilsson UW, Johns TG, Wilmann T, et al. Effects of gefitinib, an epidermal growth factor receptor inhibitor, on human placental cell growth. Obstet Gynecol. 2013;122:737.
48. Skubisz MM, Horne AW, Johns TG, et al. Combination gefitinib and methotrexate compared with methotrexate alone to treat ectopic pregnancy. Obstet Gynecol. 2013; 122:745.
49. Korhonen J, Stenman UH, Ylöstalo P. Low-dose oral methotrexate with expectant management of ectopic pregnancy. Obstet Gynecol. 1996;88:775.
50. Webster K, Eadon H, Fishburn S, et al. Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance. BMJ. 2019;367:l6283.
51. Ectopic pregnancy and miscarriage: diagnosis and initial management. NICE guideline [NG126]. National Institute for Health Care Excellence. April. 2019. Available at: https://www.nice.org.uk/guidance/ng126/chapter/Recommendations#management-of-miscarriage. Accessed: 03.03.2021.
52. Bachman EA, Barnhart K. Medical management of ectopic pregnancy: a comparison of regimens. Clin Obstet Gynecol. 2012;55:440.
53. van Mello NM, Mol F, Verhoeve HR, et al. Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomized comparison. Hum Reprod. 2013;28:60.
54. Jurkovic D, Memtsa M, Sawyer E, et al. Single-dose systemic methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo-controlled randomized trial. Ultrasound Obstet Gynecol. 2017;49:171.
55. van Mello NM, Mol F, Adriaanse AH, et al. The METEX study: methotrexate versus expectant management in women with ectopic pregnancy: a randomised controlled trial. BMC Womens Health. 2008;8:10.
56. Silva PM, Araujo Júnior E, Cecchino GN, et al. Effectiveness of expectant management versus methotrexate in tubal ectopic pregnancy: a double-blind randomized trial. Arch Gynecol Obstet. 2015;291:939.
57. van Mello NM, Mol F, Hajenius PJ, et al. Randomized comparison of health-related quality of life in women with ectopic pregnancy or pregnancy of unknown location treated with systemic methotrexate or expectant management. Eur J Obstet Gynecol Reprod Biol. 2015;192:1.
58. Craig LB, Khan S. Expectant management of ectopic pregnancy. Clin Obstet Gynecol. 2012;55:461.
59. Dooley W, De Braud L, Memtsa M, et al. Physical resolution of tubal ectopic pregnancy on ultrasound imaging following successful expectant management. Reprod Biomed Online. 2020;40:880.
60. Strobelt N, Mariani E, Ferrari L, et al. Fertility after ectopic pregnancy. Effects of surgery and expectant management. J Reprod Med. 2000;45:803.
61. Helmy S, Sawyer E, Ofili-Yebovi D, et al. Fertility outcomes following expectant management of tubal ectopic pregnancy. Ultrasound Obstet Gynecol. 2007;30:988.
2. Справочник Министерства здравоохранения Российской Федерации. M., 2019; c. 30 [Spravochnik Ministerstva zdravookhraneniia Rossiiskoi Federatsii. Moscow, 2019; p. 30 (in Russian)].
3. Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol. 2005;105:1052.
4. Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol. 2010;115:495.
5. Stulberg DB, Cain LR, Dahlquist I, Lauderdale DS. Ectopic pregnancy rates and racial disparities in the Medicaid population. 2004–2008. Fertil Steril. 2014;102:1671.
6. Mann LM, Kreisel K, Llata E, et al. Trends in Ectopic Pregnancy Diagnoses in United States Emergency Departments. 2006–2013. Matern Child Health J. 2020;24:213.
7. Stulberg DB, Cain L, Dahlquist IH, Lauderdale DS. Ectopic pregnancy morbidity and mortality in low-income women. 2004–2008. Hum Reprod. 2016;31:666.
8. Creanga AA, Shapiro-Mendoza CK, Bish CL, et al. Trends in ectopic pregnancy mortality in the United States: 1980–2007. Obstet Gynecol. 2011;117:837.
9. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111:1479.
10. Practice Committee of American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013;100:638.
11. Willner N, Storch S, Tadmor T, Schiff E. Almost a tragedy: severe methotrexate toxicity in a hemodialysis patient treated for ectopic pregnancy. Eur J Clin Pharmacol. 2014;70:261.
12. Menon S, Colins J, Barnhart KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril. 2007;87:481.
13. Lipscomb GH, McCord ML, Stovall TG, et al. Predictors of success of methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med. 1999;341:1974.
14. Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing "single dose" and "multidose" regimens. Obstet Gynecol. 2003;101:778.
15. Nazac A, Gervaise A, Bouyer J, et al. Predictors of success in methotrexate treatment of women with unruptured tubal pregnancies. Ultrasound Obstet Gynecol. 2003;21:181.
16. Gamzu R, Almog B, Levin Y, et al. The ultrasonographic appearance of tubal pregnancy in patients treated with methotrexate. Hum Reprod. 2002;17:2585.
17. Vermesh M, Graczykowski JW, Sauer MV. Reevaluation of the role of culdocentesis in the management of ectopic pregnancy. Am J Obstet Gynecol. 1990;162:411.
18. Bixby S, Tello R, Kuligowska E. Presence of a yolk sac on transvaginal sonography is the most reliable predictor of single-dose methotrexate treatment failure in ectopic pregnancy. J Ultrasound Med. 2005;24:591.
19. Potter MB, Lepine LA, Jamieson DJ. Predictors of success with methotrexate treatment of tubal ectopic pregnancy at Grady Memorial Hospital. Am J Obstet Gynecol. 2003;188:1192.
20. Dudley PS, Heard MJ, Sangi-Haghpeykar H, et al. Characterizing ectopic pregnancies that rupture despite treatment with methotrexate. Fertil Steril. 2004;82:137.
21. Takacs P, Rodriguez L. High folic acid levels and failure of single-dose methotrexate treatment in ectopic pregnancy. Int J Gynaecol Obstet. 2005;89:301.
22. Levine Y, Yahav L, Schwarzman P, et al. The correlation between endometrial thickness and the criteria for MTX treatment for ectopic pregnancy. J Obstet Gynaecol. 2021;41:1230.
23. Fang T, Chen M, Yu W, et al. The predictive value of endometrial thickness in 3117 fresh IVF/ICSI cycles for ectopic pregnancy. J Gynecol Obstet Hum Reprod. 2021;50:102072.
24. Hoyos LR, Malik M, Najjar M, et al. Morbid obesity and outcome of ectopic pregnancy following capped single-dose regimen methotrexate. Arch Gynecol Obstet. 2017;295:375.
25. Levin G, Meyer R, Dior U, et al. Outcome of methotrexate treatment for ectopic pregnancies among obese women. J Gynecol Obstet Hum Reprod. 2020;101790.
26. Mol F, Mol BW, Ankum WM, et al. Current evidence on surgery, systemic methotrexate and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod Update. 2008;14:309.
27. Morlock RJ, Lafata JE, Eisenstein D. Cost-effectiveness of single-dose methotrexate compared with laparoscopic treatment of ectopic pregnancy. Obstet Gynecol. 2000;95:407.
28. Nieuwkerk PT, Hajenius PJ, Ankum WM, et al. Systemic methotrexate therapy versus laparoscopic salpingostomy in patients with tubal pregnancy. Part I. Impact on patients' health-related quality of life. Fertil Steril. 1998;70:511.
29. Grimes DA. Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999. Am J Obstet Gynecol. 2006;194:92.
30. Oriol B, Barrio A, Pacheco A, et al. Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve. Fertil Steril. 2008;90:1579.
31. Wiser A, Gilbert A, Nahum R, et al. Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle. Reprod Biomed Online. 2013;26:449.
32. Gay C, Perrin J, Courbiere B, et al. Impact of salpingectomy for ectopic pregnancy on the ovarian response during IVF stimulation. J Gynecol Obstet Hum Reprod. 2019;48:727.
33. Ohannessian A, Loundou A, Courbière B, et al. Ovarian responsiveness in women receiving fertility treatment after methotrexate for ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod. 2014;29:1949.
34. Strauss JF, Williams CJ. The ovarian life cycle. In: Yen and Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management, 5th ed., Strauss JF, Barbieri RL (Eds.), Elsevier Saunders, Philadelphia, 2004; p. 213.
35. Svirsky R, Rozovski U, Vaknin Z, et al. The safety of conception occurring shortly after methotrexate treatment of an ectopic pregnancy. Reprod Toxicol. 2009;27:85.
36. Chouinard M, Mayrand MH, Ayoub A, et al. Ectopic pregnancy and outcomes of future intrauterine pregnancy. Fertil Steril. 2019;112:112.
37. Lipscomb GH, Givens VM, Meyer NL, Bran D. Comparison of multidose and single-dose methotrexate protocols for the treatment of ectopic pregnancy. Am J Obstet Gynecol. 2005;192:1844.
38. Hajenius PJ, Mol F, Mol BW, et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;CD000324.
39. Alur-Gupta S, Cooney LG, Senapati S, et al. Two-dose versus single-dose methotrexate for treatment of ectopic pregnancy: a meta-analysis. Am J Obstet Gynecol. 2019;221:95.
40. Jermy K, Thomas J, Doo A, Bourne T. The conservative management of interstitial pregnancy. BJOG. 2004;111:1283.
41. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins – Gynecology. ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy. Obstet Gynecol. 2018;131:e91.
42. Stovall TG, Ling FW. Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol. 1993;168:1759.
43. Natale A, Candiani M, Barbieri M, et al. Pre- and post-treatment patterns of human chorionic gonadotropin for early detection of persistence after a single dose of methotrexate for ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol. 2004;117:87.
44. Saraj AJ, Wilcox JG, Najmabadi S, et al. Resolution of hormonal markers of ectopic gestation: a randomized trial comparing single-dose intramuscular methotrexate with salpingostomy. Obstet Gynecol. 1998;92:989.
45. Tang A, Baartz D, Khoo SK. A medical management of interstitial ectopic pregnancy: a 5-year clinical study. Aust N Z J Obstet Gynaecol. 2006;46:107.
46. Xiao C, Shi Q, Cheng Q, Xu J. Non-surgical management of tubal ectopic pregnancy: A systematic review and meta-analysis. Medicine (Baltimore). 2021;100:e27851.
47. Nilsson UW, Johns TG, Wilmann T, et al. Effects of gefitinib, an epidermal growth factor receptor inhibitor, on human placental cell growth. Obstet Gynecol. 2013;122:737.
48. Skubisz MM, Horne AW, Johns TG, et al. Combination gefitinib and methotrexate compared with methotrexate alone to treat ectopic pregnancy. Obstet Gynecol. 2013; 122:745.
49. Korhonen J, Stenman UH, Ylöstalo P. Low-dose oral methotrexate with expectant management of ectopic pregnancy. Obstet Gynecol. 1996;88:775.
50. Webster K, Eadon H, Fishburn S, et al. Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance. BMJ. 2019;367:l6283.
51. Ectopic pregnancy and miscarriage: diagnosis and initial management. NICE guideline [NG126]. National Institute for Health Care Excellence. April. 2019. Available at: https://www.nice.org.uk/guidance/ng126/chapter/Recommendations#management-of-miscarriage. Accessed: 03.03.2021.
52. Bachman EA, Barnhart K. Medical management of ectopic pregnancy: a comparison of regimens. Clin Obstet Gynecol. 2012;55:440.
53. van Mello NM, Mol F, Verhoeve HR, et al. Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomized comparison. Hum Reprod. 2013;28:60.
54. Jurkovic D, Memtsa M, Sawyer E, et al. Single-dose systemic methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo-controlled randomized trial. Ultrasound Obstet Gynecol. 2017;49:171.
55. van Mello NM, Mol F, Adriaanse AH, et al. The METEX study: methotrexate versus expectant management in women with ectopic pregnancy: a randomised controlled trial. BMC Womens Health. 2008;8:10.
56. Silva PM, Araujo Júnior E, Cecchino GN, et al. Effectiveness of expectant management versus methotrexate in tubal ectopic pregnancy: a double-blind randomized trial. Arch Gynecol Obstet. 2015;291:939.
57. van Mello NM, Mol F, Hajenius PJ, et al. Randomized comparison of health-related quality of life in women with ectopic pregnancy or pregnancy of unknown location treated with systemic methotrexate or expectant management. Eur J Obstet Gynecol Reprod Biol. 2015;192:1.
58. Craig LB, Khan S. Expectant management of ectopic pregnancy. Clin Obstet Gynecol. 2012;55:461.
59. Dooley W, De Braud L, Memtsa M, et al. Physical resolution of tubal ectopic pregnancy on ultrasound imaging following successful expectant management. Reprod Biomed Online. 2020;40:880.
60. Strobelt N, Mariani E, Ferrari L, et al. Fertility after ectopic pregnancy. Effects of surgery and expectant management. J Reprod Med. 2000;45:803.
61. Helmy S, Sawyer E, Ofili-Yebovi D, et al. Fertility outcomes following expectant management of tubal ectopic pregnancy. Ultrasound Obstet Gynecol. 2007;30:988.
________________________________________________
2. Spravochnik Ministerstva zdravookhraneniia Rossiiskoi Federatsii. Moscow, 2019; p. 30 (in Russian).
3. Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol. 2005;105:1052.
4. Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol. 2010;115:495.
5. Stulberg DB, Cain LR, Dahlquist I, Lauderdale DS. Ectopic pregnancy rates and racial disparities in the Medicaid population. 2004–2008. Fertil Steril. 2014;102:1671.
6. Mann LM, Kreisel K, Llata E, et al. Trends in Ectopic Pregnancy Diagnoses in United States Emergency Departments. 2006–2013. Matern Child Health J. 2020;24:213.
7. Stulberg DB, Cain L, Dahlquist IH, Lauderdale DS. Ectopic pregnancy morbidity and mortality in low-income women. 2004–2008. Hum Reprod. 2016;31:666.
8. Creanga AA, Shapiro-Mendoza CK, Bish CL, et al. Trends in ectopic pregnancy mortality in the United States: 1980–2007. Obstet Gynecol. 2011;117:837.
9. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111:1479.
10. Practice Committee of American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013;100:638.
11. Willner N, Storch S, Tadmor T, Schiff E. Almost a tragedy: severe methotrexate toxicity in a hemodialysis patient treated for ectopic pregnancy. Eur J Clin Pharmacol. 2014;70:261.
12. Menon S, Colins J, Barnhart KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril. 2007;87:481.
13. Lipscomb GH, McCord ML, Stovall TG, et al. Predictors of success of methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med. 1999;341:1974.
14. Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing "single dose" and "multidose" regimens. Obstet Gynecol. 2003;101:778.
15. Nazac A, Gervaise A, Bouyer J, et al. Predictors of success in methotrexate treatment of women with unruptured tubal pregnancies. Ultrasound Obstet Gynecol. 2003;21:181.
16. Gamzu R, Almog B, Levin Y, et al. The ultrasonographic appearance of tubal pregnancy in patients treated with methotrexate. Hum Reprod. 2002;17:2585.
17. Vermesh M, Graczykowski JW, Sauer MV. Reevaluation of the role of culdocentesis in the management of ectopic pregnancy. Am J Obstet Gynecol. 1990;162:411.
18. Bixby S, Tello R, Kuligowska E. Presence of a yolk sac on transvaginal sonography is the most reliable predictor of single-dose methotrexate treatment failure in ectopic pregnancy. J Ultrasound Med. 2005;24:591.
19. Potter MB, Lepine LA, Jamieson DJ. Predictors of success with methotrexate treatment of tubal ectopic pregnancy at Grady Memorial Hospital. Am J Obstet Gynecol. 2003;188:1192.
20. Dudley PS, Heard MJ, Sangi-Haghpeykar H, et al. Characterizing ectopic pregnancies that rupture despite treatment with methotrexate. Fertil Steril. 2004;82:137.
21. Takacs P, Rodriguez L. High folic acid levels and failure of single-dose methotrexate treatment in ectopic pregnancy. Int J Gynaecol Obstet. 2005;89:301.
22. Levine Y, Yahav L, Schwarzman P, et al. The correlation between endometrial thickness and the criteria for MTX treatment for ectopic pregnancy. J Obstet Gynaecol. 2021;41:1230.
23. Fang T, Chen M, Yu W, et al. The predictive value of endometrial thickness in 3117 fresh IVF/ICSI cycles for ectopic pregnancy. J Gynecol Obstet Hum Reprod. 2021;50:102072.
24. Hoyos LR, Malik M, Najjar M, et al. Morbid obesity and outcome of ectopic pregnancy following capped single-dose regimen methotrexate. Arch Gynecol Obstet. 2017;295:375.
25. Levin G, Meyer R, Dior U, et al. Outcome of methotrexate treatment for ectopic pregnancies among obese women. J Gynecol Obstet Hum Reprod. 2020;101790.
26. Mol F, Mol BW, Ankum WM, et al. Current evidence on surgery, systemic methotrexate and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod Update. 2008;14:309.
27. Morlock RJ, Lafata JE, Eisenstein D. Cost-effectiveness of single-dose methotrexate compared with laparoscopic treatment of ectopic pregnancy. Obstet Gynecol. 2000;95:407.
28. Nieuwkerk PT, Hajenius PJ, Ankum WM, et al. Systemic methotrexate therapy versus laparoscopic salpingostomy in patients with tubal pregnancy. Part I. Impact on patients' health-related quality of life. Fertil Steril. 1998;70:511.
29. Grimes DA. Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999. Am J Obstet Gynecol. 2006;194:92.
30. Oriol B, Barrio A, Pacheco A, et al. Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve. Fertil Steril. 2008;90:1579.
31. Wiser A, Gilbert A, Nahum R, et al. Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle. Reprod Biomed Online. 2013;26:449.
32. Gay C, Perrin J, Courbiere B, et al. Impact of salpingectomy for ectopic pregnancy on the ovarian response during IVF stimulation. J Gynecol Obstet Hum Reprod. 2019;48:727.
33. Ohannessian A, Loundou A, Courbière B, et al. Ovarian responsiveness in women receiving fertility treatment after methotrexate for ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod. 2014;29:1949.
34. Strauss JF, Williams CJ. The ovarian life cycle. In: Yen and Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management, 5th ed., Strauss JF, Barbieri RL (Eds.), Elsevier Saunders, Philadelphia, 2004; p. 213.
35. Svirsky R, Rozovski U, Vaknin Z, et al. The safety of conception occurring shortly after methotrexate treatment of an ectopic pregnancy. Reprod Toxicol. 2009;27:85.
36. Chouinard M, Mayrand MH, Ayoub A, et al. Ectopic pregnancy and outcomes of future intrauterine pregnancy. Fertil Steril. 2019;112:112.
37. Lipscomb GH, Givens VM, Meyer NL, Bran D. Comparison of multidose and single-dose methotrexate protocols for the treatment of ectopic pregnancy. Am J Obstet Gynecol. 2005;192:1844.
38. Hajenius PJ, Mol F, Mol BW, et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;CD000324.
39. Alur-Gupta S, Cooney LG, Senapati S, et al. Two-dose versus single-dose methotrexate for treatment of ectopic pregnancy: a meta-analysis. Am J Obstet Gynecol. 2019;221:95.
40. Jermy K, Thomas J, Doo A, Bourne T. The conservative management of interstitial pregnancy. BJOG. 2004;111:1283.
41. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins – Gynecology. ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy. Obstet Gynecol. 2018;131:e91.
42. Stovall TG, Ling FW. Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol. 1993;168:1759.
43. Natale A, Candiani M, Barbieri M, et al. Pre- and post-treatment patterns of human chorionic gonadotropin for early detection of persistence after a single dose of methotrexate for ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol. 2004;117:87.
44. Saraj AJ, Wilcox JG, Najmabadi S, et al. Resolution of hormonal markers of ectopic gestation: a randomized trial comparing single-dose intramuscular methotrexate with salpingostomy. Obstet Gynecol. 1998;92:989.
45. Tang A, Baartz D, Khoo SK. A medical management of interstitial ectopic pregnancy: a 5-year clinical study. Aust N Z J Obstet Gynaecol. 2006;46:107.
46. Xiao C, Shi Q, Cheng Q, Xu J. Non-surgical management of tubal ectopic pregnancy: A systematic review and meta-analysis. Medicine (Baltimore). 2021;100:e27851.
47. Nilsson UW, Johns TG, Wilmann T, et al. Effects of gefitinib, an epidermal growth factor receptor inhibitor, on human placental cell growth. Obstet Gynecol. 2013;122:737.
48. Skubisz MM, Horne AW, Johns TG, et al. Combination gefitinib and methotrexate compared with methotrexate alone to treat ectopic pregnancy. Obstet Gynecol. 2013; 122:745.
49. Korhonen J, Stenman UH, Ylöstalo P. Low-dose oral methotrexate with expectant management of ectopic pregnancy. Obstet Gynecol. 1996;88:775.
50. Webster K, Eadon H, Fishburn S, et al. Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance. BMJ. 2019;367:l6283.
51. Ectopic pregnancy and miscarriage: diagnosis and initial management. NICE guideline [NG126]. National Institute for Health Care Excellence. April. 2019. Available at: https://www.nice.org.uk/guidance/ng126/chapter/Recommendations#management-of-miscarriage. Accessed: 03.03.2021.
52. Bachman EA, Barnhart K. Medical management of ectopic pregnancy: a comparison of regimens. Clin Obstet Gynecol. 2012;55:440.
53. van Mello NM, Mol F, Verhoeve HR, et al. Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomized comparison. Hum Reprod. 2013;28:60.
54. Jurkovic D, Memtsa M, Sawyer E, et al. Single-dose systemic methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo-controlled randomized trial. Ultrasound Obstet Gynecol. 2017;49:171.
55. van Mello NM, Mol F, Adriaanse AH, et al. The METEX study: methotrexate versus expectant management in women with ectopic pregnancy: a randomised controlled trial. BMC Womens Health. 2008;8:10.
56. Silva PM, Araujo Júnior E, Cecchino GN, et al. Effectiveness of expectant management versus methotrexate in tubal ectopic pregnancy: a double-blind randomized trial. Arch Gynecol Obstet. 2015;291:939.
57. van Mello NM, Mol F, Hajenius PJ, et al. Randomized comparison of health-related quality of life in women with ectopic pregnancy or pregnancy of unknown location treated with systemic methotrexate or expectant management. Eur J Obstet Gynecol Reprod Biol. 2015;192:1.
58. Craig LB, Khan S. Expectant management of ectopic pregnancy. Clin Obstet Gynecol. 2012;55:461.
59. Dooley W, De Braud L, Memtsa M, et al. Physical resolution of tubal ectopic pregnancy on ultrasound imaging following successful expectant management. Reprod Biomed Online. 2020;40:880.
60. Strobelt N, Mariani E, Ferrari L, et al. Fertility after ectopic pregnancy. Effects of surgery and expectant management. J Reprod Med. 2000;45:803.
61. Helmy S, Sawyer E, Ofili-Yebovi D, et al. Fertility outcomes following expectant management of tubal ectopic pregnancy. Ultrasound Obstet Gynecol. 2007;30:988.
Авторы
Ю.Э. Доброхотова1, Т.Н. Белоусова2, Е.И. Боровкова*1, Н.И. Соваев2, В.Д. Егорушкина2, А.Д. Кладницкая1, А. Ермакова1
1ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2ГБУЗ МО «Видновский перинатальный центр», Видное, Россия
*Katyanikitina@mail.ru
1Pirogov Russian National Research Medical University, Moscow, Russia;
2Vidnovsky Perinatal Center, Vidnoe, Russia
*Katyanikitina@mail.ru
1ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2ГБУЗ МО «Видновский перинатальный центр», Видное, Россия
*Katyanikitina@mail.ru
________________________________________________
1Pirogov Russian National Research Medical University, Moscow, Russia;
2Vidnovsky Perinatal Center, Vidnoe, Russia
*Katyanikitina@mail.ru
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