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Methotrixate for nonsurgical management of ectopic pregnancy | ||
| Al-Qadisiah Medical Journal | ||
| Article 1, Volume 9, Issue 2, 2013, Pages 95-108 PDF (0 K) | ||
| Author | ||
| Ariana Kh. Jawad | ||
| Abstract | ||
| Systemic Methotrexate has been widely used to treat ectopic pregnancy.The aim of current study were to evaluate the safety and efficacy of single dose intramuscular methotrexate as a treatment option for early unruptured ectopic pregnancies. From 1st of January 2007 to 1st of January 2009 at Maternity teaching Hospital-Erbil, a case cohort prospective study was conducted on 60 patients with small unruptured ectopic pregnancies treated as in-patients with single dose of Methotrexate therapy. Ectopic pregnancy was diagnosed by both transvaginal ultrasound for the size and volume of the gestational mass and β-HCG measurement. Intramuscular methotrexate 50 mg/m2 was administered on days 1 and Serial ß-hcg was repeated on days 4 and 7, If the β-HCG on day 7was at least 15% lower than that on day 4, the patient was regarded as treatment success, and Follow-up serum ß-HCG was performed weekly until become negative ( value of <15 mIU/ml). while additional doses(second dose) of methotrexate were given on day 7 If the ß-HCG level on day 7 was the same or higher or less than 15% lower than that on day 4. The success rate of systemic methotrexate (single dose) was 75%(n-45), 25%(n=15) exposed to 2 or more doses of methotrexate ,16.6%(n=10) of patients exposed to multidose methotrexate respond to treatment, remain only 8.3%(n=5) not respond to multidose treatment they were treated surgically ,in which 2 cases of them operation done for them on their request after one dose of methotrexate, and other 3 cases were failed to respond to medical treatment after receiving 3 dose of methotrexate. The over all success rate of treatment in our study(medical treatment) was 91%(n=55).Success rate was higher in patients whom with β-HCG was ≤ 1500 mIU .Treatment was well-tolerated; most side effects were reported as mild and transient. All cases respond to methotrexate reported satisfaction with this regimen. Within two years follow up visit 38 cases become pregnant , 2 of them developed recurrent ectopic pregnancy. | ||
| Keywords | ||
| Ectopic pregnancy; Methotrexate; medical management; safety | ||
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