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Oral methotrexate for persistent ectopic pregnancy. A case report.

J M DiMarchi¹, R E Cyka

¹Department of Obstetrics and Gynecology, Malcolm Grow Medical Center, Andrews Air Force Base, Maryland.

The Journal of Reproductive Medicine

|July 1, 1992

Summary

Persistent ectopic pregnancy can be successfully treated with oral methotrexate, avoiding surgery. This approach offers a convenient outpatient option for persistent trophoblast following conservative procedures.

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Persistent ectopic pregnancy.

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Area of Science:

Reproductive Medicine
Gynecologic Oncology

Background:

Persistent ectopic pregnancy is a complication of conservative tubal pregnancy procedures.
Optimal treatment for persistent trophoblast remains undetermined, with reoperation being common.

Observation:

This case report details a persistent ectopic pregnancy successfully treated with an oral methotrexate regimen.
The regimen was originally developed for nonmetastatic gestational trophoblastic neoplasia.

Findings:

Oral methotrexate provided a simple, convenient, and effective outpatient treatment.
Treatment was indicated by rising or plateauing human chorionic gonadotropin levels post-conservative surgery.

Implications:

Methotrexate may offer an alternative to reoperation, enabling tubal salvage.

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This approach simplifies management and improves patient convenience for persistent ectopic pregnancy.