title: Low-dose methotrexate treatment in ectopic pregnancy: a retrospective analysis of 164 ectopic pregnancies treated between 2000 and 2008.
abstract: OBJECTIVE
  Ectopic pregnancy is an acute, potentially life-threatening condition. The aim of this study was to compare the results of surgery and methotrexate treatment in women with ectopic pregnancy, along with a review of the literature.
  
  
  METHODS
  164 women with ectopic pregnancy, treated from 2000 to 2008 at the university gynecology department, were examined in a retrospective analysis. Patients with diagnosed ectopic pregnancy underwent one of the following treatments: Salpingotomy, salpingectomy or administration of a single dose of 30 mg methotrexate. The main outcome measures were treatment success rate, rate of patients wishing to have children after the ectopic pregnancy, and rates of pregnancy, live births, recurrent ectopic pregnancy, miscarriage, use of assisted reproduction and side effects.
  
  
  RESULTS
  There were no significant differences in success rates between the groups (methotrexate 83.9 %, salpingotomy 88.2 %, salpingectomy 96.8 %). Significantly more patients in the salpingotomy group wished to become pregnant afterward than in the salpingectomy group. No significant differences were observed between the groups in the rates of intrauterine pregnancy, live births, recurrences, miscarriages, or side effects.
  
  
  CONCLUSIONS
  With defined inclusion criteria, similar results can be achieved with low-dose single administration of 30 mg methotrexate in comparison with surgical treatment for ectopic pregnancy. On the basis of the data presented here, further research to establish optimal dosages for methotrexate is needed.
authors.affiliation: Department of Obstetrics and Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany, johannes.lermann@uk-erlangen.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Lermann
authors.forename: Petra
authors.initials: P
authors.lastname: Segl
authors.forename: Sebastian M
authors.initials: SM
authors.lastname: Jud
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Peter
authors.initials: P
authors.lastname: Oppelt
authors.forename: Falk C
authors.initials: FC
authors.lastname: Thiel
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Renner
authors.forename: Andreas
authors.initials: A
authors.lastname: Müller
mesh_terms: D000328:Adult; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005493:Folic Acid Antagonists / Q000008:administration & dosage*; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy* / Q000601:surgery; D012189:Retrospective Studies; D058994:Salpingectomy; D016896:Treatment Outcome
chemical_list: D005493:Folic Acid Antagonists; D008727:Methotrexate