title: Medical management of ectopic pregnancy.
abstract: The use of medical management of ectopic pregnancy has become an accepted alternative to surgical therapy. Methotrexate, a folic acid antagonist, is the most widely studied agent. The most commonly used protocol consists of methotrexate 50 mg/m of actual body weight. Assessment of human chorionic gonadotropin (hCG) levels is repeated on days 4 and 7. Repeat methotrexate dosing is performed for hCG drops < 15%. Contraindications include hemodynamically unstable patients or those with elevated liver enzymes, low white blood count, or abnormal renal function. hCG levels are most predictive of success. A success rate of above 90% is achievable.
authors.affiliation: Department of Family Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA. glipscomb@uthsc.edu
authors.forename: Gary H
authors.initials: GH
authors.lastname: Lipscomb
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects; D006063:Chorionic Gonadotropin / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D006063:Chorionic Gonadotropin; D008727:Methotrexate