Medical management of interstitial pregnancy with high serum beta-selective human chorionic gonadotrophin

Abstract

Medical management of interstitial ectopic pregnancy with high baseline beta-selective human chorionic gonadotrophin ( β-hCG) is controversial and there is no consensus on the best treatment option. Here we review the use of methotrexate (MTX) therapy for interstitial ectopic pregnancy, illustrated by three cases in which baseline serum β-hCG levels above 8000 IU/L were successfully managed by systemic MTX therapy. Primary MTX therapy appears to be a promising approach to managing interstitial pregnancy. It offers a safe and effective non-surgical method of treating selected patients even with a high concentration of baseline serum β-hCG. A randomized controlled trial comparing this regimen in interstitial pregnancy with high β-hCG with surgical management is required to substantiate the success and safety of this modality of treatment.