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Analysis of three hundred fifteen ectopic pregnancies treated with single-dose methotrexate
G H Lipscomb1, D Bran, M L McCord
1Department of Obstetrics and Gynecology, University of Tennessee, Memphis, USA.
Objectives:
The objective of this study was to review the largest single series of ectopic pregnancies treated with single-dose methotrexate reported to date.
Study Design:
A review of 315 patients with unruptured ectopic pregnancies treated with single-dose methotrexate 50 mg/m2 from March 21, 1990, to March 1, 1997, was performed.
Results:
Overall 287 patients were successfully treated with methotrexate for a success rate of 90.1%. Six patients electively withdrew and requested surgery within 1 week of starting therapy. Excluding withdrawals the overall success rate was 92.9%. Ten patients with an ectopic pregnancy > 3.5 cm but < or = 4 cm in size were treated for a 90% success rate. Forty-four patients with positive ectopic cardiac activity were treated with an 87.5% success rate.
Conclusions:
This large series indicates that single-dose intramuscular methotrexate for treatment of ectopic pregnancy is associated with an excellent overall success rate.