Non-surgical treatment of ectopic pregnancy : three years experience

Abstract EN

A retrospective chart review was performed of all patients with intact ectopic pregnancies that were treated initially with methotrexate from January 1999 to December 2001.

Fifty patients satisfied the inclusion criteria.

The presence of an ectopic gestational sac and/or an adnexal mass consistent with an ectopic pregnancy was demonstrated by vaginal ultrasonography in 30 (60 %) of 50 women.

Methotrexate was successful in 46 (92 %) out of 50 patients.

The size of the ectopic mass was lower in the successfully treated women.

Logistic regression analysis revealed a size of ectopic mass > 3 cm to be the only factor significantly linked to failure of treatment with methotrexate (p = 0.008).

Methotrexate achieved a 92 % success rate in selected intact ectopic pregnancies.

When the ectopic pregnancy mass was > 3 cm in largest diameter, there was a greater probability of requiring either surgical intervention or a second dose of methotrexate.

Eight percent of all patients required emergency surgical intervention after methotrexate treatment.

Women with intact ectopic pregnancies selected methotrexate treatment must be counseled about success rate, must undergo serial human chorionic gonadotrophin titers, and must be fully compliant with close monitoring for possible emergency surgical intervention.