Medical treatment of ectopic pregnancy: a ten-year review of 106 cases at Maharaj Nakorn Chiang Mai Hospital.
OBJECTIVE
To evaluate the effectiveness of single-dose intramuscular methotrexate in the treatment of ectopic pregnancy at Maharaj Nakorn Chiang Mai Hospital


METHODS
A retrospective review of the patient records was performed on the patients with diagnosis of ectopic pregnancy and treatment with single-dose methotrexate according to the protocol of Stovall et al between 1996 and 2005. The successful treatment was defined as no need for surgical intervention.


RESULTS
As many as 96 out of 106 (90.6%) were successfully treated with methotrexate, though four required a second dose. Pretreatment /f-human chorionic gonadotropin (beta-hCG) levels were significantly lower in women who responded to single-dose therapy than either in those who required two doses or who had a failure of medical management (p < 0. 01). The mean pretreatment level of beta-hCG was 873 mlU/ml. The median time to resolution of beta-hCG was 21 days. In addition, all cases with failed medical treatment had adnexal masses larger than 3.5 centimeters in diameter


CONCLUSIONS
In the present series, treatment of ectopic pregnancy with single-dose methotrexate was as high as 90% successful. Women with a high pretreatment beta-hCG level and large sonographic adnexal masses had a greater probability of requiring either surgical intervention or multiple doses of methotrexate.
Srivichai
Karnchana
K
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Uttavichai
Chumnong
C
Tongsong
Theera
T
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*; D012189:Retrospective Studies; D013785:Thailand; D013997:Time Factors; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate