[Medical treatment of ectopic pregnancy with methotrexate about 69 cases]

ABSTRACT

Analysis of medical treatment of ectopic pregnancy with methotrexate. Via a retrospective study we have considered a sample of 69 patients having ectopic pregnancy treated with methotrexate [1mg/Kg IM]. All patients were diagnosed at the Gynecology and Obstetrics Unit A at Charles Nicole Hospital, Tunisia. the average age is around 32.8 years [19-43 years]. We have noted amenorrhea in 76.81%of cases while pelvic pain and vaginal bleeding were observed respectively in 68.11%and 75 .36%of the cases. The ultrasound examination highlighted an adenexal mass in 95.65%of cases. The average size was around 20.66 +/- 7.3 mm. The average level of beta HCG was around 1067.97mtJlJml with extremes between 42 and 4163 mUI/ml. A second MTX injection was necessary for 24 patients, while a third one was compulsory only for one patient. A success rate of 58%was observed after a single dose of MTX. The same rate goes up to 88.4%with a second dose and to 89.85%with a third one. We have observed a failure in 7 cases through a symptomatic hemoperitoneum. We have conducted an operative laparoscopy in five cases out of seven and laparotomy for the two other patients. The medical treatment with MTX is considered to be a pillar in the management of ectopic pregnancy. The variety and heterogeneity of the research studies available has Led to the absence of consensus over the proposed treatment