المعالجة بالميتوتركسات في الحمل الهاجر
Abstract
This study was conducted at Tishreen Hospital University in the department of obstetrics and gynecology between 1/1/2016 -1/1/2018 on the patients of symptoms of pregnancy, which classified depending on Fernandez score, The number of patients was 50 patients. We have mad for each patient the following
1- Climical history
2- Vagimal Echography
3- BHCG
4- Proqestme imserwe
5- CBC
6- Amalqsisol lives and kidmy
We gave a unique dose of methotrexate 1 mg/ kg for each patient.after one week we give another close if the number of BHCG still high in the 4th and 7th day,we observed if the number of BHW in day 2-4-6 then after every week until we have the value of BHCG = negative plow Blood analysis after one week . The results were as follows:1- The percentage of multipara patient was 84% and the age of the patients were most between 20-30 years2- The percentage of the patients with who cesarean section was 60% and the percentage of one abortion least was 48%3- After the treatment of methotrexate the pain reduced in 78% and the bleeding reduced in 70% 4- We were forced to repent the does one after week in 16% on the cases 5- The treatment of methotrexate was not succeed in 8% of the cases6- We did not pimd any side effects on this treatment with one dose in 100% of the patientsأجريت هذه الدراسة في قسم التوليد وأمراض النساء ما بين 1/1/2016 و1/1/2018 على المريضات المقبولات بأعراض حمل هاجر وتم تحديد المريضات المؤهلات للعلاج الدوائي وذلك حسب مشعر فرنانديز كان عدد المريضات 50 مريضة. حيث تم أخد قطعة مفصلة لكل مريضة وتم اجراء الايكو المهبلي مع معايرات BHCG وعيار البروجسترون المصلي – تعداد وصيغة – وظائف الكبد والكلية
تم إعطاء جرعة وحيدة 1mg /كغ عضلي من الميتوتركسات , تعاد الجرعة بعد أسبوع اذا كانت قيم BHCG لم تنخفض بين اليوم الرابع والسابع , مراقبة BHCG في اليوم 2-4-6 ثم كل أسبوع حتى سلبيه BHCG اجراء تحاليل دموية بعد أسبوع
وكانت النتائج كالتالي:
1- كانت نسبة الولودات في دراستنا 84% وأغلب المريضات كانت في الفئة العمرية بين 20-30 سنه
2- كانت نسبة المريضات اللواتي خضعن للعمل القيصري 60% من كان لديهن سوابق اجهاض 48%
3- نتائج المعالجة بعد إعطاء جرعة الميتوتركسات هي تراجع الألم بنسبة 78% والنزف بنسبة 70%
4- تم إعادة الجرعة بعد أسبوع لدى 16% من المريضات
5- لم تنجح المعالجة الدوائية لدى 4 مريضات أي بنسبة 8%
6- بالمراقبات المخبرية لم يلاحظ وجود أي اثار جانبية أو اسمية للميتوتركسات
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