MODERN APPROACHES TO THE CONSERVATIVE TREATMENT OF ECTOPIC PREGNANCY: DRUGS FOR THE FUTURE PERSPECTIVE
DOI:
https://doi.org/10.32782/health-2024.2.3Keywords:
ectopic pregnancy, methotrexate, letrozole, gefitinib, absolute ethanol, potassium chloride.Abstract
Ectopic pregnancy remains a common emergency gynecological condition worldwide, with an incidence of 20 per 1000 confirmed pregnancies. At the moment, there is no single highly effective conservative treatment for ectopic pregnancy – therapy depends on the location of the ovum and the patient’s condition. Surgery is considered a relatively highly effective method of treatment, but there is a significant risk of developing postoperative complications and a new case of ectopic pregnancy. Conservative therapy consists of the use of methotrexate in single-dose and multi-dose regimens. And although the effectiveness of treatment with methotrexate is quite high (according to many sources, it ranges from 70–90%), some patients are unable to use it due to the development of side effects or non-compliance with the criteria for prescribing the drug. Some studies indicate successful conservative treatment of ectopic pregnancy with alternative drugs, which include aromatase inhibitors (letrozole), epidermal growth factor receptor tyrosine kinase domain inhibitors (gefitinib), absolute ethanol, and potassium chloride. This article analyzes the results of conservative management of ectopic pregnancy using alternative drugs. Treatment options for ectopic pregnancy should depend on its location. Different localizations of ectopic pregnancy, as well as some features (high levels of β-hCG, presence of fetal heartbeat) require the selection of an individual approach to therapy. Ectopic pregnancy in the cervix or in the uterus after cesarean section is more accessible to the administration of topical drugs, which have proven their effectiveness in a large number of studies. Tubal pregnancy is less widely available, but new drugs including letrozole and gefitinib (even when used in combination with methotrexate) may reduce adverse events, improve efficacy, and change the de facto gold standard.
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