Abstract
Background: Medical treatment of ectopic pregnancy with methotrexate has been considered as an alternative to surgical intervention. Aims and objectives: The present was carried with an aim to determine the role of methotrexate in management of ectopic pregnancy. Materials and methods: The present study was carried out for a period of 5 years (September 2007 to August 2012) in a tertiary care hospital. It included a total of 128 patients of unruptured ectopic pregnancies. The medical management was done with methotrexate. Time taken for complete β human chorionic gonadotrophin (β hCG) resolution was recorded. The negative β hCG result indicated as an endpoint of successful outcome. Results: Out of 128 cases where Methotrexate was used, 4 required surgery. In remaining 124 cases, there were no side effects. Complete β hCG resolution was achieved in 28 -35 days. Subsequent tubal patency & reproductive functions were comparable to that of surgical management. Conclusion: From our study, it can be concluded that methotrexate can be recommended as safe and effective drug for management of unruptured ectopic pregnancies.
Highlights
An Ectopic Pregnancy refers to the pregnancy occurring outside the uterine cavity usually in fallopian tube. 1 It is a potentially life threatening condition.Currently over 90% of ectopic pregnancies can be visualized on transvaginal Scan ( TVS) and early ectopic pregnancies can often be detected in asymptomatic patients
High resolution TVS along with rapid immunoassay of serum β human chorionic gonadotrophin (β hCG) allows the early diagnosis of ectopic pregnancy and early medical treatment can be administered in most of the cases.[2]
Normal βhCG levels were achieved in 28-35 days in 122 patients while 2 patients took 42 days for their βhCG to return to normal
Summary
An Ectopic Pregnancy refers to the pregnancy occurring outside the uterine cavity usually in fallopian tube. 1 It is a potentially life threatening condition.Currently over 90% of ectopic pregnancies can be visualized on transvaginal Scan ( TVS) and early ectopic pregnancies can often be detected in asymptomatic patients. Methotrexate is a folic acid antagonist widely used for treatment of neoplasia, severe psoriasis & rheumatoid arthritis. It inhibits DNA synthesis & cell reproduction primarily in actively proliferating cells such as malignant cells, www.ssjournals.com trophoblast & fetal cells.[1] The dose of methotrexate used to treat ectopic pregnancy (50mg/m2 or 1mg/kg) is relatively low. Aims and objectives: The present was carried with an aim to determine the role of methotrexate in management of ectopic pregnancy. Conclusion: From our study, it can be concluded that methotrexate can be recommended as safe and effective drug for management of unruptured ectopic pregnancies.
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