Single-dose systemic methotrexate for the treatment of persistent ectopic pregnancy after conservative surgery.
OBJECTIVE
To determine whether a single outpatient methotrexate injection successfully treats persistent ectopic pregnancy.


METHODS
Nineteen consecutive patients with increasing beta-hCG titers after conservative surgery for ectopic pregnancy were treated with a single intramuscular methotrexate (50 mg/m2) injection.


RESULTS
All 19 patients had resolution of their beta-hCG titers without subsequent surgery. Beta-hCG levels commonly increased during the first 3 days after treatment, but subsequently declined. Two patients required hospital admission for observation and analgesia. One of these two patients had probable self-limited intra-abdominal bleeding and required a blood transfusion.


CONCLUSIONS
A single methotrexate injection is a safe and successful treatment for persistent ectopic pregnancy. Delayed hemorrhage may be a rare complication, and close surveillance is necessary.
Hoppe
D E
DE
Department of Reproductive Medicine, University of California, School of Medicine, San Diego.
Bekkar
B E
BE
Nager
C W
CW
D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D017211:Treatment Failure
D006063:Chorionic Gonadotropin; D008727:Methotrexate