Abstract
Severe methotrexate toxicity due to medical treatment of an ectopic pregnancy is presented. The feasibility of low-dose use and success of methotrexate makes it the first drug in the medical treatment of ectopic pregnancies. Besides its advantages, it should be used with caution and severe toxicity should be kept in mind.
Highlights
The feasibility of low-dose use and success of methotrexate makes it the first drug in the medical treatment of ectopic pregnancies. It should be used with caution and severe toxicity should be kept in mind
Ectopic pregnancy is a serious condition in gynecologic practice
The inhibitory effect on DNA synthesis of MTX is the rationale in the treatment of ectopic pregnancy in which the target is trophoblasts and fetal cells
Summary
Ectopic pregnancy is a serious condition in gynecologic practice. Treatment options for ectopic pregnancy include surgical treatment, expectant management, and medical treatment. MTX is a folic acid antagonist and is generally used for the treatment of malignancies, autoimmune diseases, and ectopic pregnancies[2]. The inhibitory effect on DNA synthesis of MTX is the rationale in the treatment of ectopic pregnancy in which the target is trophoblasts and fetal cells. Low-dose use of MTX gives freedom to a physician to use it frequently in the treatment of ectopic pregnancies. MTX treatment has two protocols; single dose and multiple dose regimens. A second dose of MTX is needed in 15-20% of cases and only 1% of women who receive the single-dose protocol require a third dose[4,5,6]. 30 percent of patients on the single-dose protocol have adverse effects; this rate is lower for patients on multi-dose regimens (40%)(7). An otherwise healthy woman who had a severe adverse event with low-dose MTX treatment is presented
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