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Oral methotrexate for treatment of ectopic pregnancy
Gary H Lipscomb1, Norman L Meyer, Darby E Flynn
1Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, USA.
Objective:
The purpose of this study was to evaluate oral methotrexate tablets in the treatment of ectopic pregnancy.
Study Design:
Patients with a diagnosis of ectopic pregnancy were offered oral methotrexate tablets rather that intramuscular injection. Oral methotrexate was given in 2 divided doses 2 hours apart at a dose of 60 mg/m(2) with standard 2.5 mg methotrexate tablets. Patients were followed up with the use of the same protocol that was used typically for intramuscular methotrexate.
Results:
Nineteen of 22 patients (86%) were successfully treated. There was no statistical difference between patients who were treated successfully or unsuccessfully, with respect to initial human chorionic gonadotropin titers (P =.55), ectopic size (P =.77), or methotrexate dose (P =.18). Nineteen of 22 patients (86%) had increased pain during treatment. Outside of pain, gastrointestinal side effects were the most common. Thirty-two percent of patients required more than one treatment cycle.
Conclusion:
Oral methotrexate can be used to treat ectopic pregnancy successfully, but there are few advantages to recommend its use over intramuscular methotrexate.