[Current indications for medical treatment of ectopic pregnancy]

Today, the early diagnosis of ectopic pregnancy (EP) is made possible by the assay of plasmatic hCG and the improvement of trans-vaginal sonography. These different tests lead to diagnose the EP before the ruptured stage. Therefore, the medical treatment is today a logical alternative to the surgical one. The medical treatment is mainly based upon the use of methotrexate (MTX). The logical indications for EP medical treatment are: early EP without peritoneum effusion, with hCG < or = 5000 mUI/ml, without embryonic cardiac activity at sonography. The medical therapy by intramuscular injection of MTX at 1 mg/kg gives a success rate of 91.8% similar to the success rate of intra tubal injection of MTX under sonographic control.