METHOD FOR DIFFERENTIATED ORGAN-PRESERVING TREATMENT OF PROGRESSIVE FALLOPIAN PREGNANCY IN INTERSTITIAL SECTION OF FALLOPIAN TUBE DEPENDING ON DATA FROM INTEGRATED ULTRASOUND INSPECTION AND LEVEL OF HUMAN CHORIONIC GONADOTROPIN IN PLASMA OF PATIENT (VERSIONS) Russian patent published in 2018 - IPC A61M5/32 A61K31/675 A61P15/06 A61B8/12 A61B8/06 G01N33/76 

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine, specifically to gynecology, and can be used for differentiated organ-preserving treatment of pregnancy in the interstitial tube section. Disclosed versions of the method include emergency hospitalisation and determination of human chorionic gonadotropin (hCG) level in blood plasma. In the first version, presence of ultrasound signs of chorionic ingrowth with formation of vascular malformation, an increase in the level of hCG in the blood plasma is an indication of bilateral embolisation of uterine arteries (EUA) with preliminary administration of methotrexate in a dose of 50 mg. Ovum is left. After 3 days, control ultrasound investigation and determination of the level of hCG in the blood plasma is performed. When the level of hCG falls by at least 25 % and there is no visual blood flow in the chorion, the patient is discharged for outpatient monitoring. If there is persistence of blood flow in the chorion, second bilateral EUA is performed with the search for corresponding vessels. With insufficient decrease in the level of hCG in the blood plasma, the patient is administered methotrexate in the cavity of the ovum in a dose of 2–10 mg. With the cessation of blood flow and a decrease in the level of hCG in the blood plasma, the patient is discharged for outpatient monitoring. In the second version of the method, in the absence of ultrasound signs of chorionic growth, the ovum is punctured under ultrasound control and 2–10 mg of methotrexate is administered, with the preliminary removal of amniotic fluid. If there is no growth of the ovum and a decrease in the level of hCG in the blood plasma by more than 25 %, the patient is discharged after 3 days under outpatient supervision. Third version of the method consists in that in the presence of ultrasound signs of chorionic ingrowth and a decreasing level of hCG in the blood plasma, bilateral EUA is performed. After 3 days, ultrasound control and determination of the level of hCG in the blood plasma are performed. When the level of hCG falls by at least 10 % and there is no visual blood flow in the chorion, the patient is discharged for outpatient monitoring.

EFFECT: inventions ensure the preservation of the integrity of the uterus and its reproductive function by creating conditions for gradual safe resorption of the ovum and abnormal vessels that result from the ingrowth of the chorion into the surrounding tissues, while reducing the length of hospitalisation.

6 cl, 3 ex