title: Comparison of success rates in the medical management of ectopic pregnancy with single-dose and multiple-dose administration of methotrexate: a prospective, randomized clinical trial.
abstract: OBJECTIVE
  To assess whether success rate differs in single-dose versus multiple-dose administration of methotrexate (MTX) in medical management of unruptured ectopic pregnancies.
  
  
  METHODS
  Prospective randomized clinical trial.
  
  
  METHODS
  Tertiary university hospital.
  
  
  METHODS
  The study population included 108 patients presenting with unruptured ectopic pregnancies who fulfilled the criteria for medical management.
  
  
  METHODS
  A single dose (study group) or multiple doses (control group) of MTX were administered IM.
  
  
  METHODS
  Success rate of medical management in each group.
  
  
  RESULTS
  Of the 54 patients on the single-dose protocol, treatment was considered successful in 48 patients (88.9%). Of the 54 patients on the multiple-dose protocol, 50 participants responded to the treatment (92.6%). The difference between success rates in the two groups was not statistically significant (P=.7; odds ratio 0.64; 95% confidence interval 0.17-2.4). In the single-dose and multiple-dose groups, 15 (27.8%) and 20 (37%) patients, respectively, had complications (P=.3).
  
  
  CONCLUSIONS
  The results of our study showed that single-dose treatment with MTX could be as successful as multiple doses. The incidence of complications did not differ between the two groups. It appears that single-dose treatment could be the first line of treatment in selected patients.
authors.affiliation: Department of Obstetrics and Gynecology, Vali-e-asr Reproductive Health Research Center, Dr. Shariati Hospital, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Alleyassin
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Khademi
authors.forename: Marzieh
authors.initials: M
authors.lastname: Aghahosseini
authors.forename: Leili
authors.initials: L
authors.lastname: Safdarian
authors.forename: Bita
authors.initials: B
authors.lastname: Badenoosh
authors.forename: Ehsan Akbari
authors.initials: EA
authors.lastname: Hamed
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology* / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D008727:Methotrexate