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Local application of methotrexate for ectopic pregnancy with a percutaneous puncturing technique
S A Mesogitis1, G J Daskalakis, A J Antsaklis
1First Department of Obstetrics and Gynaecology, Athens University Medical School, Alexandra Maternity Hospital, Greece.
Gynecologic and Obstetric Investigation
|June 13, 1998
Summary
Local injection of methotrexate (MTX) effectively treats ectopic pregnancies, offering a less invasive alternative to surgery. This method shows high success rates with minimal side effects, making it a viable conservative treatment option.
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
- Pharmacology
Background:
- Ectopic pregnancy management traditionally involves surgery.
- Early detection enables conservative treatment options.
- Ultrasound and beta-human chorionic gonadotropin (beta-hCG) aid early diagnosis.
Purpose of the Study:
- To evaluate the efficacy of local methotrexate (MTX) injection for treating tubal pregnancies.
- To assess the safety and effectiveness of percutaneous MTX administration under sonographic guidance.
Main Methods:
- Twenty-six cases of tubal pregnancy managed with percutaneous MTX injection into the gestational sac.
- Ultrasound guidance was used for accurate injection.
- A single dose of 10-12.5 mg MTX was administered, with a second dose if necessary.
Main Results:
- Complete resolution of ectopic pregnancies in all patients.
- Four patients required a second MTX administration.
- Serum beta-hCG levels normalized (< 10 mIU/ml) within 42 days.
- No systemic side effects were observed.
Conclusions:
- Local MTX injection under sonographic control is an effective and safe alternative for ectopic pregnancy treatment.
- Potential advantages include enhanced antitrophoblastic effect, shorter treatment, reduced dosage, and absence of systemic side effects.