Gynecology And Obstetrics-

Therapy of ectopic pregnancy

Synonyms

Tubal pregnancy, tubal pregnancy,

Medical: Graviditas tubaria
English: tubal pregnancy

therapy

The therapy of an ectopic pregnancy depends on how long the pregnancy has existed and how acute the situation is.

Surgical therapy is aimed at removing the parts of the pregnancy. If the ectopic pregnancy is older, i.e. it is at an advanced stage, a surgical procedure is necessary. The fallopian tube as such can also be functionally preserved. During the operation, either the Fallopian tubes cut lengthways and the embryonic material is removed or the embryo and the Plaster cake (placenta) are both towards the uterus or expressed in the direction of the fringed funnel. However, this can only be done if the size and position of the embryo allow it.

If the ectopic pregnancy is not advanced and it cannot be assumed that the pregnancy will resolve on its own, the drug can be used Methotrexate can be used.

Trade name methotrexate

Lantarel ® from Wyeth Pharma GmbH
Metex ® from medac
MTX

Active ingredient: Methotrexate disodium

field of use

Methotexate has many areas of application as a drug.

Low dose methotrexate, has become one of the most prescribed long-acting drugs Anti-inflammatory drugs developed. Methotrexate can also cause reactions of the Immune system suppress (Immunosuppressant) and is therefore used for diseases in which there are disorders of the body's own defenses.
In the further area of application Methotrexate in the treatment of various malignant Tumor diseases used. As mentioned above, methotrexate is also used in one that is not advanced Ectopic pregnancy used.

effect

Methotrexate is an opponent of Folic acid (Folic acid antagonist) and inhibits the reproduction of rapidly dividing cells. That's the Starting point for the therapy of an ectopic pregnancy. Methotrexate also weakens unwanted immune reactions and also has an anti-inflammatory effect. Therapy with methotrexate is generally long-term.

Side effects

The Side effects from Methotrexate depends on the duration of use and the dosage. It is possible that the side effects will occur throughout the period of use, with side effects most commonly occurring within the first 6 months. The different side effects are listed below, in order of decreasing frequency of occurrence:

Loss of appetite
nausea
Vomit
stomach pain
diarrhea
Sores and sores in the mouth and throat
Increase in liver values (GOT, GPT, alkaline phosphatase)
Disorders of blood cell formation with a pathological decrease in red blood cells (Erythrocytes) and white blood cells (leukocytes) and platelets (Platelets)
allergic Conditional inflammation of the lungs and the Alveoli (Pneumonitis, alveolitis)
increased tendency to Hair loss
Reddening of the skin
skin rash
itching
a headache
fatigue
Drowsiness

Notice

Methotrexate is an opponent of Folic acid and therefore these symptoms can be at least partially improved by taking folic acid at the same time.
However, the use of folic acid supplements should definitely be clarified with the doctor, as excessive doses of folic acid could possibly impair the effectiveness of methotrexate.

Dosage form

Methotrexate is either swallowed as a tablet or as a liquid put into your vein by your doctor (Intravenously), the subcutaneous fatty tissue (Subcutaneous) or the muscles (Intramuscular) injected. The choice between the different dosage forms is made individually.

Contraindication

Methotrexan should not be used in:

Liver damage
Kidney dysfunction
Known allergy to methotrexate
Diseases of the blood-forming system
Infections
Increased alcohol consumption
Gastrointestinal ulcers

interaction

Interactions:

An increased toxicity of methotrexate has been observed in the presence of a folic acid deficiency or the simultaneous use of drugs that cause a folic acid deficiency (e.g. sulfonamides, trimethoprim-sulfamethoxazole).

Taking methotrexate and alcohol at the same time should be avoided. When taking other liver-damaging drugs at the same time (e.g. retinoids, sulfasalazine, leflunomide, Azathioprin®) should be checked regularly by the doctor.
The same applies to the simultaneous intake of sulfonamides, trimethoprim-sulfamethoxazole, chloramphenicol, pyrimethamine.

Live vaccinations should not be required while taking methotrexate.

An indirect dose increase can be drugs like