Methotrexate injection by hysteroscopic tubal catheterization in the treatment of unruptured tubal pregnancy / 中国微创外科杂志

ABSTRACT

Objective To evaluate the short-term effects of methotrexate (MTX) injection by hysteroscopic tubal catheterization for unruptured tubal pregnancy, and to investigate factors influencing curative effects of such approach. Methods A total of 82 patients with unruptured tubal pregnancy underwent injection of MTX 20 mg (10ml) by hysteroscopic tubal catheterization from October 2000 to September 2002. Clinical efficiency and side effects were recorded. After administration for 72 hours, in case serum ?-HCG level had dropped less than 50 percent, a second injection of MTX was given. Results The total cure rate was 82.9% (68/82), and 72.0% (59/82) of the patients were cured clinically with the first administration of MTX, with the length of hospitalization being (10?4.9) days. Statistically, the drug reflux at injection, the declining level of ?-HCG after administration, and the serum level of ?-HCG ≥ 4000 mIu/ml before administration significantly influenced the curative effects (P=0.000, P=0.001, P=0.032, respectively). No side effects were found in this study. Out of the 65 cured patients followed up for 2 months,57 (87.7%) got normal menstruation. Conclusions MTX injection by hysteroscopic tubal catheterization for unruptured tubal pregnancy is effective, simple, minimally invasive and safe.