title: Role of routine monitoring of liver and renal function during treatment of ectopic pregnancies with single-dose methotrexate protocol.
abstract: OBJECTIVE
  To assess whether or not baseline serum transaminases and creatinine measurements, before administration of methotrexate, identified significant liver or kidney disease, which have the potential to alter the management plan for the treatment of ectopic pregnancies.
  
  
  METHODS
  This is a retrospective study of patients treated for ectopic pregnancy.
  
  
  METHODS
  Women's emergency room and reproductive endocrinology office at a teaching hospital over a 3-year period.
  
  
  METHODS
  Women presenting for treatment of ectopic pregnancy.
  
  
  METHODS
  None.
  
  
  METHODS
  Assessment of baseline serum transaminases and creatinine measurements before administration of methotrexate to identify significant liver or kidney disease.
  
  
  RESULTS
  A total of 383 patients were managed for ectopic pregnancy from January 2006 to December 2008. Of these, 320 patients received methotrexate as part of their treatment. No patient was denied treatment with methotrexate secondary to concerns regarding liver or renal function. No complication related to methotrexate administration was documented. A subgroup of 81 patients had pre- and postadministration labs, and no significant difference was noted upon comparing the values.
  
  
  CONCLUSIONS
  Routine measurement of serum aspartate aminotransferase and creatinine levels may not be necessary before instituting a single-dose methotrexate treatment regimen for the management of ectopic pregnancy.
authors.affiliation: Women and Infants Hospital, Department of Obstetrics and Gynecology and Warren Alpert Medical School at Brown University, Providence, Rhode Island 02906, USA. linclark@wihri.org
authors.forename: Lindsay E
authors.initials: LE
authors.lastname: Clark
authors.forename: Bala
authors.initials: B
authors.lastname: Bhagavath
authors.forename: Carol A
authors.initials: CA
authors.lastname: Wheeler
authors.forename: Gary N
authors.initials: GN
authors.lastname: Frishman
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Carson
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000503:physiopathology; D003955:Diagnostic Tests, Routine; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D007677:Kidney Function Tests / Q000379:methods; D008099:Liver / Q000187:drug effects / Q000502:physiology; D008111:Liver Function Tests / Q000379:methods; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate