Management of tubal pregnancy with methotrexate.

British Journal of Obstetrics and Gynaecology
H ZakutD Bernstein

Abstract

Ten women with tubal ectopic pregnancy were treated by the injection of methotrexate into the gestational sac under direct laparoscopic vision followed by a course of intramuscular therapy including folinic acid rescue. One course of treatment induced resolution of the extrauterine pregnancy in eight women. Complete resolution (beta-hCG less than 10 miu/ml) was achieved within 6-47 days (mean 14.5 days). Serum beta-hCG levels started to decline 3.4 days from the beginning of therapy. Length of hospital stay was 5-11 days (mean 6.4 days). Treatment failed in two patients. One woman had a laparoscopic tubal clip sterilization concomitantly with methotrexate treatment. Tubal patency was demonstrated in all the other seven women (100%) tested subsequently. There is a need to establish criteria for patient selection before methotrexate becomes a routine treatment for tubal pregnancy.

References

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Citations

Sep 23, 1992·European Journal of Obstetrics, Gynecology, and Reproductive Biology·D BiderS Mashiach
Apr 1, 1993·European Journal of Obstetrics, Gynecology, and Reproductive Biology·B LindblomJ Thorburn
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Jan 1, 1995·Archives of Gynecology and Obstetrics·M KleinP Husslein

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