Systemic treatment of ectopic pregnancies with single-dose methotrexate.
OBJECTIVE
To evaluate the success rate, side effects, reproductive outcome, and possible pitfalls of systemic low-dose methotrexate (MTX) for treatment of ectopic pregnancy (EP).


METHODS
Longitudinal, nonrandomized trial Setting. Department of Obstetrics and Gynaecology at a teaching hospital in Germany.


METHODS
Forty women with EP were treated with a single dose of MTX 20 to 40 mg intravenously. The highest pretreatment human chorionic gonadotropin (hCG) titer was 21,100 mIU/ml.


RESULTS
Thirty-seven patients (92.5%) were treated successfully. Thirty-four (85%) received a single dose of MTX. Six (15%) required a second dose about a week later. Three patients (7. 5%) required surgical intervention. Serum MTX levels decreased below 0.1 micromol/L (45.4 microg/L) within 24 hours. In 53.8% of women hCG levels decreased directly after treatment; in 46.2% levels increased within the first 5 days after treatment.


CONCLUSIONS
In selected patients, systemic low-dose MTX is an effective way to treat EP, and has no demonstrable side effects.
Schäfer
D
D
Department of Obstetrics and Gynaecology, University of Frankfurt am Main, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.
Kryss
J
J
Pfuhl
J
J
Baumann
R
R
D000328:Adult; D006063:Chorionic Gonadotropin / Q000032:analysis / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005493:Folic Acid Antagonists / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008137:Longitudinal Studies; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
D006063:Chorionic Gonadotropin; D005493:Folic Acid Antagonists; D008727:Methotrexate