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Risk factors for methotrexate treatment failure in tubal ectopic pregnancy: a retrospective cohort study.
BMC Pregnancy Childbirth
December 2024
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, People's Republic of China.
Background: Ectopic pregnancy (EP) accounts for approximately 2% of all pregnancies, with tubal ectopic pregnancies (TEPs) being the most common type. Methotrexate (MTX) is a noninvasive and effective medical management option for TEP, but failure rates range from 10 to 36%, posing challenges in clinical practice. Identifying risk factors for MTX treatment failure is crucial to improve patient outcomes and guide clinical decision-making.
View Article and Find Full Text PDFThe effect of biological treatment on female fertility: A cohort study of women with rheumatoid arthritis and psoriatic arthritis.
Semin Arthritis Rheum
December 2024
The IVF Unit, Hadassah Medical Center Mount Scopus, Jerusalem, Israel; Department of Obstetrics and Gynecology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Objectives: To investigate female fertility in patients with rheumatoid arthritis (RA) exposed to biological drugs.
Methods: In this retrospective cohort study, based on an electronic health record database, 4517 women with RA were compared to 1415 patients with psoriatic arthritis (PsA). Patients were 18-40 years-of-age at diagnosis.
Navigating obstetric enigma: Placenta accreta spectrum masquerading as gestational trophoblastic neoplasia.
Trop Doct
December 2024
Professor and Head, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
Placenta accreta spectrum (PAS) represents a complex obstetric condition characterised by the abnormal invasion of anchoring villi and trophoblast into the myometrium. This case report explores two instances where the diagnosis of PAS was overlooked during antenatal care leading to significant complications during conservative management. Both patients presented with heavy menstrual bleeding and raised beta human chorionic gonadotrophin (β-hCG), mimicking gestational trophoblastic disease.
View Article and Find Full Text PDFEvaluating single-dose methotrexate alone versus methotrexate with letrozole for treating ectopic pregnancy: a comparative study.
Arch Gynecol Obstet
December 2024
Faculty of Medicine, Department of Gynecology and Obstetrics, Van Yuzuncu Yil University, Van, Turkey.
Purpose: Ectopic pregnancy (EP) constitutes 1-2% of all pregnancies. Methotrexate (MTX) is commonly used in treating EP, but it has some limitations and potential side effects. Clinical studies have shown that letrozole, an aromatase inhibitor, may potentially be used in conjunction with MTX therapy.
View Article and Find Full Text PDFA FSH-secreting pituitary adenoma discovered after ovarian hyperstimulation syndrome: a case report, illustrating pitfalls in the interpretation of serum FSH levels.
BMC Womens Health
December 2024
Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
Background: Most cases of ovarian hyperstimulation syndrome (OHSS) are caused by infertility treatment using human menopausal gonadotropin (HMG) and human chorionic gonadotropin (hCG). OHSS is widely known to have a "spoke-wheel" appearance on imaging, presenting as bilateral symmetric enlargement of ovaries with multiple cysts of varying sizes. When this spoke-wheel appearance is observed in patients not undergoing infertility treatment, tumor-derived hormones such as follicle-stimulating hormone (FSH) and hCG should be measured.
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