Medical Management of Ectopic Pregnancy with Methotrexate.

ABSTRACT

Objective: The aim of this study is to determine the efficacy of methotrexate treatment for ectopic pregnancies in our settings, which will in-turn help us reduce maternal mortality and morbidity. Material and methods: This was a retrospective study of 40 cases of unruptured ectopic pregnancy treated with methotrexate in civil hospital, Ahmedabad. Clinical presentation, treatment, progress, outcome, side effects and future fertility follow-up were analyzed using database from May 2008 to June 2012. Results: The success rate of methotrexate therapy in our study was 85% (n = 35) and 15% (n = 06) required surgical intervention compared to reported success rate of 67-100% published in various studies. The mean average time of resolution of ectopic pregnancy was 32 days for a single dose and 58 days for repeat second doses. Successful fertility outcome with intrauterine pregnancy was observed in three patients. Conclusion: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. Intramuscular methotrexate has the advantage of tubal conservation and saves patients from surgical intervention. Our study showed single dose methotrexate to be an effective treatment option for selected patients with unruptured tubal ectopic pregnancy.