Methotrexate for Treatment of Tubal Pregnancy / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate value of methotretrexate (MTX) in the treatment of tubal pregnancy. METHODS: 28 patients with unruptured tubal pregnancy were treated alternately with four doses of intramuscular MTX (1.0 mg/kg) and four doses of intramuscular citrovorum factor (0.1 mg/kg). Patients considered eligible for MTX treatment of tubal pregnancy were those with unruptured tubal pregnancy ultrasonography (USG). On the 7th day after treatment, patients were measured for level of serum beta-subunit of human chorionic gonadotropin (beta-hCG) and underwent vaginal USG. Serum beta-hCG and USG were checked every week until the level of beta-hCG and the finding of USG were normalized.

RESULTS:

26 patients (92.9%) showed normal level in serum beta-hCG and normal fingings in USG after MTX/citrovorum factor therapy. Mean age of the patients was 29.1 years (range 20-41 years). Mean gestational age was 6 weeks (range 5 weeks-8 weeks 2 days). Mean gestational sac size was 19.3 +/- 8.42 mm (range 8-33 mm). Fetal heart beat was absent in all cases on USG. Mean beta-hCG at diagnosis was 3199 +/- 2145 mIU/ml (range 235-6650 mIU/ml). Mean resolution time of beta-hCG was 32.6 +/- 14.24 days (range 12-62 days). Two patients showed increasing concentrations of beta-hCG after therapy and they underwent salpingectomy. No patient experienced severe complications such as vomiting, diarrhea, bone marrow aplasia, ulcerative stomatitis, dermatitis, pneumonitis and alopecia.

CONCLUSION:

MTX is safe and effective as a primary therapy for those with unruptured tubal pregnancy