Management of tubal pregnancy with methotrexate.
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.
Zakut
H
H
Department of Obstetrics and Gynaecology, Edith Wolfson Medical Center, Holon, Israel.
Sadan
O
O
Katz
A
A
Dreval
D
D
Bernstein
D
D
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005260:Female; D006801:Humans; D010535:Laparoscopy; D002955:Leucovorin / Q000627:therapeutic use; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000188:drug therapy*; D013997:Time Factors
D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D002955:Leucovorin; D008727:Methotrexate