[Initial experience with a minidose of methotrexate in the management of unruptured ectopic pregnancy]

Methotrexate has been used in the conservative management of ectopic pregnancy with good results. Due to its great afinity for the trophoblast it was decided to try unique doses of 50 mg i.m. independently of the body surface. Fifteen patients were studied with ectopic pregnancy by ultrasound and hCG in series that didn't require confirmatory laparoscopy. The ectopic pregnancies broken and/or decompensated were discarded. Average gestational age was 6.1 weeks; the maximal dimention of the sacs was 36.8 mm average; the values for hCG average were 6440 mU/ml and the maximal time of negativization was 52 days. One patient required laparoscopy and salpingostomy, lineal, for inminent rupture 24 hour after methotrexate, the other 14 presented with complete remission. There were no colateral effects. From the 15 patients, in 6 tubal permeability was confirmed by laparoscopy or HSG, being positive in 6 patients, it has not been evaluated, two patients with resolved pregnancy, and other on course (two of them with one salpinx). The proposed management seems to be useful in ectopic pregnancy with success, equivalent to surgical management, and other programs of medical management, with out side effects and with greater easiness of administration.