Methotrexate vs. Surgery in the Management of Ectopic Pregnancy: A Comparative Analysis of Treatment Outcomes

Methotrexate (MTX) is a non-invasive alternative to surgery for ectopic pregnancy, a condition in which a fertilized egg implants outside the uterine cavity and poses serious hazards to the mother.

This study aimed to compare the effectiveness, safety, and reproductive outcomes of MTX versus surgical intervention in the management of ectopic pregnancy.

A two-year comparative study was conducted from 2022 to 2024, with 260 women diagnosed with unruptured ectopic pregnancies. Participants were randomized to either the surgical group (n = 130) or the MTX group (n = 130). The surgical group had either open or laparoscopic surgery, and MTX was given as a single dose. In addition to gathering laboratory, clinical, and demographic data, patients were monitored for three months. IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States) was used for statistical analysis.

One hundred twenty-eight out of 130 patients (98.46%) in the surgical group had a successful course of therapy, while 114 out of 130 patients (87.69%) in the MTX group saw a favorable result (p=0.001). With a mean hospital stay of 1.2 ± 0.5 days, the MTX group had fewer problems than the surgical group, which saw a mean hospital stay of 3.0 ± 1.2 days (p<0.001). In terms of reproductive outcomes, 95 out of 130 patients (73.08%) in the surgical group and 89 out of 130 patients (68.46%) in the MTX group went on to get pregnant intrauterine (p=0.56).

Surgery has a greater success rate than MTX when it comes to treating ectopic pregnancy, but MTX has benefits in terms of hospital stay and recuperation after surgery. Treatment decisions need to be tailored to each patient's unique clinical situation.