title: [Medical treatment of ectopic pregnancy].
abstract: BACKGROUND
  The ectopic pregnancy (EP) is a public health problem and its frequency has doubled in most industrialized countries in 20 years. aim: To evaluate the effectiveness of medical treatment of ectopic pregnancy with methotrexate (MTX) intramuscularly (IM).
  
  
  METHODS
  prospective study supported between October 2006 and December 2010. The selected patients received methotrexate IM (1 mg per kg). The monitoring was based on: the kinetics of plasma HCG, clinical examination and ultrasound. A second injection was performed if hCG on day 4 was increased by more than 25% or J7> the initial rate. Healing corresponded to obtain a zero rate of HCG in a stable manner.
  
  
  RESULTS
  We used the first-line medical treatment in 122 patients. The average age of patients was 31.94 years. A haematosalpinx was found in 87.70% of cases. The initial rate of HCG plasma varied between 40 IU/ml and 4088 IU / ml, with an average of 805.88 m IU / ml. The primary success rate obtained after a single injection of intramuscular MTX was 67%. The high success rate obtained after two injections of MTX was 27%. The overall success rate after 1 or 2 injections of MTX was 82%. 17 patients underwent surgical treatment after a first injection of methotrexate. 5 patients underwent surgery after receiving two doses of methotrexate. The period of normalization of plasma levels of h CG was 24 days on average, with extremes ranging from 4 to 43 days for 67 patients cured after a single injection of MTX. This period was 33 days on average, with extremes ranging from 8 to 62 days for patients healed after two injections of MTX.
  
  
  CONCLUSIONS
  Medical treatment applied to 38% of ectopic pregnancies diagnosed in our department is effective in 82% of cases if the inclusion criteria are strictly adhered to. Successful treatment is limited by patient compliance and demanding nature of monitoring.
authors.forename: Nabil
authors.initials: N
authors.lastname: Mathlouthi
authors.forename: Olfa
authors.initials: O
authors.lastname: Slimani
authors.forename: Amira
authors.initials: A
authors.lastname: Ferchichi
authors.forename: Riadh
authors.initials: R
authors.lastname: Ben Temime
authors.forename: Tahar
authors.initials: T
authors.lastname: Makhlouf
authors.forename: Leila
authors.initials: L
authors.lastname: Attia
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Chachia
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010298:Parity; D017699:Pelvic Pain / Q000139:chemically induced / Q000453:epidemiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate