GynecologyGynecologyГинекология2079-56962079-5831Consilium Medicum15938110.26442/20795696.2023.4.202518REVIEWS AND CASE REPORTSОБЗОРЫ И КЛИНИЧЕСКИЕ СЛУЧАИReview ArticleNon-surgical management of patients with ectopic pregnancy: A reviewКонсервативная тактика ведения пациенток с внематочной беременностьюhttps://orcid.org/0000-0002-7830-2290DobrokhotovaYulia E.ДоброхотоваЮлия Эдуардовна
Russian Federation

D. Sci. (Med.), Prof.

доктор медицины наук, проф., зав. каф. акушерства и гинекологии лечебного фак-та

pr.dobrohotova@mail.ruhttps://orcid.org/0000-0003-3804-7691BelousovaTamara N.БелоусоваТамара Николаевна
Russian Federation

Cand. Sci. (Med.)

кандидат медицинских наук, глав. врач

beltamara1@mail.ruhttps://orcid.org/0000-0001-7140-262XBorovkovaEkaterina I.БоровковаЕкатерина Игоревна
Russian Federation

D. Sci. (Med.), Assoc. Prof.

доктор медицины наук, доц., проф. каф. акушерства и гинекологии

Katyanikitina@mail.ruhttps://orcid.org/0000-0002-5452-805XSovaevNikolai I.СоваевНиколай Иванович
Russian Federation

Head of the Gynecological Department

зав. гинекологическим отд-нием

nsovaev@yandex.ruhttps://orcid.org/0000-0002-1134-5704EgorushkinaVera D.ЕгорушкинаВера Дмитриевна
Russian Federation

obstetrician-gynecologist

врач акушер-гинеколог

verusiettt27@gmail.comhttps://orcid.org/0000-0003-4199-0365KladnitskayaAnastasia D.КладницкаяАнастасия Дмитриевна
Russian Federation

Student

студентка каф. акушерства и гинекологии лечебного фак-та

nastya.kladnitskaya@mail.ruhttps://orcid.org/0000-0002-5240-6251ErmakovaAnnaЕрмаковаАнна
Russian Federation

Student

студентка каф. акушерства и гинекологии лечебного фак-та

ermakova.rsmu@mail.ruPirogov Russian National Research Medical UniversityФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииVidnovsky Perinatal CenterГБУЗ МО «Видновский перинатальный центр»201220232544354413001202330012024Copyright ©; 2023, Consilium MedicumCopyright ©; 2023, ООО "Консилиум Медикум"2023Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://gynecology.orscience.ru/2079-5831/article/view/159381

An ectopic pregnancy is a medical emergency. Currently, surgery is the main method of therapy, and non-surgical management with methotrexate is considered an acceptable alternative. Methotrexate is a folic acid antagonist and has an inhibitory effect on the proliferation of trophoblast cells. There are various methotrexate regimens; the choice is based on the level of β-subunit of human chorionic gonadotropin, the location of the ectopic pregnancy and the patient's adherence to treatment. Therapy of ectopic tubal pregnancy with methotrexate is an effective and safe alternative to surgical treatment, does not affect the ovarian reserve and preserves the woman's fertility.

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.

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