Transvaginal intratubal methotrexate treatment of ectopic pregnancy.
OBJECTIVE
To evaluate the efficacy of transvaginal intratubal methotrexate (MTX) treatment of tubal ectopic pregnancy (EP).


METHODS
Outpatient setting in University Hospital.


METHODS
Forty women with early EP and rising serum beta-human chorionic gonadotropin (beta-hCG) levels.


METHODS
Transvaginal intratubal administration of MTX (1 mg/kg body weight).


METHODS
Success was defined as declining serum beta-hCG to undetectable levels, no tubal dilatation on ultrasound examination, and no further intervention was required.


RESULTS
Treatment was associated with a 70% success rate. No difference was found in the success rate between women with an embryo (76.9%) and those with no embryo in their fallopian tubes (66.7%). The initial serum beta-hCG levels were also not different between patients who were successfully treated and those who failed to respond to the treatment. Despite declining serum beta-hCG levels, tubal rupture occurred in two patients.


CONCLUSIONS
Treatment of EP by transvaginal MTX administration is associated with a 70% success rate. This is independent of the presence of an embryo or the initial serum beta-hCG levels. Rupture of EP can still occur despite low and declining serum beta-hCG levels.
Tulandi
T
T
Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Atri
M
M
Bret
P
P
Falcone
T
T
Khalife
S
S
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D005187:Fallopian Tubes; D005260:Female; D006801:Humans; D007267:Injections; D008727:Methotrexate / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*; D014621:Vagina
D006063:Chorionic Gonadotropin; D008727:Methotrexate