Document Detail


Efficacy and safety of single-dose systemic methotrexate in the treatment of ectopic pregnancy.
MedLine Citation:
PMID:  7926078     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the safety and efficacy of single-dose systemic methotrexate (MTX) in the treatment of ectopic pregnancy (EP). DESIGN: A database was started and continued prospectively for 35 patients meeting criteria for MTX therapy from June 1991 to October 1993. Follow-up was performed retrospectively on all patients with EPs (n = 82) by evaluating hospital and clinic records and by contacting affiliated physicians and individual patients. SETTING: The University of Vermont Reproductive Endocrinology Service. INTERVENTIONS: Methotrexate 50 mg/m2 was administered IM; blood samples were collected on days 0, 4, and 7 of MTX therapy and weekly thereafter until hCG titers became < 4 mIU/mL. RESULTS: Thirty-five of 82 (42.7%) patients diagnosed with EP were treated with MTX. The mean hCG concentration on day of treatment was 1388.1 +/- 463.5 (+/- SE) mIU/mL, and mean time to complete resolution of hCG was 23.1 +/- 2.9 days. Thirty of 35 (85.7%) were successfully treated with a single dose of MTX. Five of 35 (14.3%) failed therapy and required laparoscopic surgery. Twelve of 35 (34.3%) experienced mild side effects that resolved spontaneously. Ten of 13 (76.9%) demonstrated tubal patency at follow-up hysterosalpingogram. Of the 15 patients seeking pregnancy, 3 of 15 (20.0%) conceived, resulting in 3 term deliveries and 2 spontaneous abortions. CONCLUSIONS: Our results support the use of single-dose systemic MTX for the treatment of unruptured EP in carefully selected patients.
Authors:
J L Glock; J V Johnson; J R Brumsted
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  62     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-11-01     Completed Date:  1994-11-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  716-21     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Vermont College of Medicine, Burlington 05405.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Chorionic Gonadotropin / blood
Dose-Response Relationship, Drug
Female
Humans
Laparoscopy
Methotrexate / administration & dosage*,  adverse effects,  therapeutic use
Pelvic Pain / etiology
Pregnancy
Pregnancy Outcome
Pregnancy, Ectopic / complications,  drug therapy*,  surgery
Prospective Studies
Treatment Failure
Treatment Outcome
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 59-05-2/Methotrexate

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