Single-Dose Systemic Methotrexate Therapy in Patients with Suspected Ectopic Pregnancy: Two year experience

Abstract

Objective:    To evaluate the safety and efficacy of single-dose systemic methotrexate in

the treatment of ectopic pregnancy.

Subjects:      Thirty-four inpatients with an unruptured ectopic pregnancy who met the

criteria for methotrexote therapy, from October 1998 to December 2000.
Intervention: Single dose of methotrexate 50 mg/m2 intramuscular injection. Blood samples
for b-hCG titer were collected weekly until the b-hCG titer became normal (0-10 mIU/ml).         

Results:        Patients had a mean age of 26.15±5.73 years, a mean gravidity of 2.06±1.04,

and a mean parity of 0.74±0.83. The mean human chorionic gonadotropin titer before
treatment initiation was 2990.24±3076.55 mIU/ml. One (2.9%) patient of 34 failed medical
therapy and required surgery. One (2.9%) patient required a second methotrexate dose.
The mean time to resolution for the 34 subjects successfully treated was 4.32±1.97 weeks.
No biochemical or clinical side effect occurred. Post-treatment hysterosalpingograms
demonstrated tubal patency on the ipsilateral side in 6 of 7 (85.7%) patients. To date, 5
pregnancies have occurred in this group, all of which were intrauterine.
Conclusion Single-dose systemic methotrexate in the treatment of ectopic pregnancy is
safe, effective and can help preserve reproductive capability when used in carefully selected
patients.