Ectopic Pregnancy Treated by Combined Laparoscopic Surgery and Methotrexate

Conservative laparoscopic surgery using only an operative laparoscope, followed by injection of methotrexate 50 mg into the proximal segment of the involved tube, was performed successfully in seven women with ectopic pregnancy. Significant decreases in beta-subunit human chorionic gonadotropin occurred at 7, 14, and 30 days. No intraoperative or postoperative surgical complications, or side effects of methotrexate occurred. Five women became pregnant, with no miscarriages or recurrent ectopic pregnancies. This combined approach is a practical alternative to current management protocols.