2024
Cost-effectiveness analysis of expectant vs active management for treatment of persistent pregnancies of unknown location
WALTER J, BARNHART K, KOELPER N, SANTORO N, ZHANG H, THOMAS T, HUANG H, HARVIE H, Network E. Cost-effectiveness analysis of expectant vs active management for treatment of persistent pregnancies of unknown location. American Journal Of Obstetrics And Gynecology 2024, 231: 328.e1-328.e11. PMID: 38552817, DOI: 10.1016/j.ajog.2024.03.035.Peer-Reviewed Original ResearchQuality-adjusted life yearsTwo-dose methotrexateUterine evacuationExpectant managementIncremental cost-effectiveness ratioPersistent pregnancyCost-effectiveness ratioSurgical managementCost-effectiveness acceptability curvesPersistent pregnancy of unknown locationLife yearsLower-risk patient populationsSerum human chorionic gonadotropinPregnancies of unknown locationLaparoscopic surgical managementRate of salpingectomyManagement of pregnancyMean quality-adjusted life yearsMulticenter randomized trialRisk patient populationLower mean costsCosts of surgical interventionsHuman chorionic gonadotropinLower quality-adjusted life yearsAcceptability curves
2021
Effect of an Active vs Expectant Management Strategy on Successful Resolution of Pregnancy Among Patients With a Persisting Pregnancy of Unknown Location
Barnhart KT, Hansen KR, Stephenson MD, Usadi R, Steiner AZ, Cedars MI, Jungheim ES, Hoeger KM, Krawetz SA, Mills B, Alston M, Coutifaris C, Senapati S, Sonalkar S, Diamond MP, Wild RA, Rosen M, Sammel MD, Santoro N, Eisenberg E, Huang H, Zhang H, Legro R, Guzick D, Branum A, Goldman M, Redmon B, Thomas M, Witter F, Brannigan R, Cato P, Coney P, Inoue L, Missmer S. Effect of an Active vs Expectant Management Strategy on Successful Resolution of Pregnancy Among Patients With a Persisting Pregnancy of Unknown Location. JAMA 2021, 326: 390-400. PMID: 34342619, PMCID: PMC8335579, DOI: 10.1001/jama.2021.10767.Peer-Reviewed Original ResearchConceptsExpectant managementInitial management strategyUterine evacuationPregnancy resolutionCommon adverse eventsExpectant management strategyEctopic pregnancyEligible patientsSuccessful resolutionAdverse eventsPrimary outcomeInherent morbidityNonviable pregnanciesStable womenNoninferiority marginClinical trialsMedical CenterMAIN OUTCOMEHigh riskPregnancyPatientsMethotrexateActive managementSubstantial crossoverPrimary hypothesis