Nonsurgical management of live tubal ectopic pregnancy by ultrasound-guided local injection and systemic methotrexate.
OBJECTIVE
To evaluate outcomes relative to treatment using systemic methotrexate (MTX) alone or systemic MTX combined with ultrasound (US)-guided local injection of potassium chloride (KCl) or MTX in women with live tubal ectopic pregnancies.


METHODS
Case-control study (Canadian Task Force classification II-2).


METHODS
Departments of Obstetrics and Gynecology in 2 hospitals in China.


METHODS
Eighty-two women with live tubal ectopic pregnancies.


METHODS
Participants in the study received treatment using either systemic MTX (n = 37; systemic treatment group) or systemic MTX and US-guided local injection of either MTX or KCl (n = 45; combined treatment group).


RESULTS
Patient clinical features and outcomes were compared. There were no significant differences between the patient groups insofar as baseline gestational age, β-human chorionic gonadotropin concentration, or size of conceptus. The success rate in patients who received combined therapy (93.3%) was much higher than in those who received only systemic treatment (73.0%) (p < .05). In the combined treatment group, the success rate was similar between women who received locally injected KCl (95.2%) and those who received locally injected MTX (91.7%).


CONCLUSIONS
The significantly higher success rate in patients who received combined US-guided local injection and systemic MTX suggests that this is an efficient nonsurgical option in women with tubal pregnancy, high serum β-human chorionic gonadotropin concentration, and fetal cardiac activity.
Department of Obstetrics and Gynecology, General Hospital of the People's Liberation Army, Chengdu Military Region, China.
Mingyi
M
Wang
Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Biliang
B
Chen
Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Jian
J
Wang
Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Xiangdong
X
Ma
Department of Obstetrics and Gynecology, General Hospital of the People's Liberation Army, Chengdu Military Region, China. Electronic address: wangyuog@163.com.
Yu
Y
Wang
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D016022:Case-Control Studies; D002681:China; D005260:Female; D005865:Gestational Age; D006801:Humans; D007267:Injections; D008727:Methotrexate / Q000627:therapeutic use*; D011189:Potassium Chloride / Q000627:therapeutic use*; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000188:drug therapy*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D055815:Young Adult
D000020:Abortifacient Agents, Nonsteroidal; D011189:Potassium Chloride; D008727:Methotrexate
KCl; Live; Methotrexate; Nonsurgical management; Tubal ectopic pregnancy; β-hCG