Role of methotrexate in ectopic pregnancy

Authors

  • Munjal J. Pandya Department of Obstetrics and Gynaecology, AMC MET Medical College, Ahmedabad, Gujarat
  • Neha V. Ninama Department of Obstetrics and Gynaecology, AMC MET Medical College, Ahmedabad, Gujarat
  • Chirag V. Thummar Department of Obstetrics and Gynaecology, AMC MET Medical College, Ahmedabad, Gujarat
  • Meet K. Patel Department of Obstetrics and Gynaecology, AMC MET Medical College, Ahmedabad, Gujarat

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205433

Keywords:

Ectopic pregnancy, Methotrexate, b-hcg

Abstract

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancy

Methods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.

Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.

Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention.

Author Biography

Neha V. Ninama, Department of Obstetrics and Gynaecology, AMC MET Medical College, Ahmedabad, Gujarat

Final year resident in obstetrics and gynecological department

References

Hankins GD, Clark SL, Cunningham FG, Gilstrap LC. Ectopic pregnancy. In: Dilmond E; Gilstrap. Operative obstetrics. New York: Appleton & Lange;. 1995: 437-456.

Lehner R, Kucera E, Jirecek S, Egarter C, Husslein P. Ectopic pregnancy. Arch Gynecol Obstet. 2000;263(3):87-92.

Oriol B, Barrio A, Pacheco A, Serna J, Zuzuarregui JL, Garcia-Velasco JA. Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve. Fertil Steril. 2008;90(5):1579-826.

Tenore JL. Ectopic pregnancy. Am Fam Physician. 2000 :15;61(4):1080-8.

Akbar N, Shami N, Anwar S, Asif S. Evaluation of predisposing factors of tubal pregnancy in multigravidas versus primigravidas. J Surg PIMS. 2002;25:20-3.

Mahboob U, Mazhar SB. Management of ectopic pregnancy: a two-year study. J Ayub Med Coll Abbottabad. 2006;18(4):34-7.

Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynecol. 2003;101(4):778-84.

Srivichai K, Uttavichai C, Tongsong T. Medical treatment of ectopic pregnancy: a ten-year review of 106 cases at Maharaj Nakorn Chiang Mai Hospital. J Med Assoc Thai. 2006;89(10):1567-71

Cho GJ, Lee SH, Shin JW, Lee NW, Kim T, Kim HJ, et al. Predictors of success of repeated injections of single-dose methotrexate regimen for tubal ectopic pregnancy. J Korean Med Sci 2006;21(1):86-9.

Erdem M, Erdem A, Arslan M, Oc A, Biberoğlu K, Gursoy R. Single-dose methotrexate for the treatment of unruptured ectopic pregnancy. Arch Gynecol Obstet. 2004;270(4):201-4.

Thia EW, Loi K, Wang JJ, Siow A. Methotrexate treatment for ectopic pregnancy at the KK Women’s and Children’s Hospital, Singapore. Singapore Med J. 2009;50(11):1058-61.

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Published

2020-12-26

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Original Research Articles