Prophylactic intratubal injection of methotrexate after linear salpingostomy for prevention of persistent ectopic...

To examine the efficacy of local methotrexate (MTX) administration following linear salpingostomy for tubal pregnancy in the prevention of persistent ectopic pregnancy (PEP).

Patients who underwent a laparoscopic linear salpingostomy between January 1996 and December 2006 were enrolled in the study. Patients who were assigned to the prophylaxis group were administered MTX (50 mg) into the tubal wall in the vicinity of the lesion immediately following linear salpingostomy (n=41). Patients who were treated without MTX were assigned to the control group (n=40). Serum human chorionic gonadotrophin levels were followed in both groups postoperatively once every 3 days until they became undetectable. The incidence of PEP was compared between the two groups.

Persistent ectopic pregnancy occurred in seven patients (17.5%) in the control group compared with zero patients in the prophylaxis group (P<0.05). There were no side-effects attributable to MTX in the prophylaxis group.

A single prophylactic intratubal injection of MTX following laparoscopic linear salpingostomy is a safe and effective regimen for the prevention of PEP.