Methotrexate therapy for ectopic pregnancy in adolescents.
OBJECTIVE
To determine the suitability and efficacy of methotrexate (MTX) therapy for adolescent patients with ectopic pregnancy.


METHODS
Patients with ectopic pregnancy were treated with methotrexate, 50 mg/m2 intramuscularly. Follow-up determinations of quantitative beta hCG levels were done on days 1, 4, and 7. They were then seen weekly until beta hCG levels were less than 15 mIU/ml.


METHODS
Adolescents with ectopic pregnancy (55 patients) received MTX therapy and comprised the study group. They were compared with 186 adults similarly treated. The groups were compared for treatment outcome and for compliance with the rigid protocol requirements.


METHODS
Treatment success was defined as a patient who required no surgical intervention and whose beta hCG levels declined to < 15 mIU/ml.


RESULTS
85% of patients required no surgical intervention following MTX injection. Surgical intervention rates were slightly higher and success rates slightly lower for adolescent patients, but these differences were not statistically significant (p = .71). Although adult patients were more likely to have a perfect compliance rating, comparison of all compliance categories showed no significant differences (p = .17).


CONCLUSIONS
MTX therapy is satisfactory for adolescent patients. It is effective, and adolescent patients are able to comply with the requirements of a rigid protocol.
McCord
M L
ML
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103, USA.
Muram
D
D
Lipscomb
G H
GH
Powell
M P
MP
Arheart
K L
KL
D000293:Adolescent; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D005493:Folic Acid Antagonists / Q000627:therapeutic use*; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D010349:Patient Compliance; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D011271:Pregnancy, Ectopic / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome
D018997:Chorionic Gonadotropin, beta Subunit, Human; D005493:Folic Acid Antagonists; D008727:Methotrexate