Document Detail

Treatment of ectopic pregnancy by transvaginal intratubal methotrexate administration.
MedLine Citation:
PMID:  2002990     Owner:  NLM     Status:  MEDLINE    
Twelve women with tubal pregnancies were treated with intratubal transvaginal methotrexate injection (1 mg/kg body weight). Serum beta-hCG levels decreased in all patients, and the resolution time from injection to undetectable beta-hCG levels was 14-120 days. In spite of declining serum beta-hCG and unruptured tubal pregnancy, two patients subsequently requested definitive treatment for their ectopic pregnancies and underwent surgery. Four of six women found to have a living embryo in their gestational sacs required a repeat methotrexate injection; one of these also required a local potassium chloride injection. The tubal pregnancies resolved in nine patients treated with methotrexate alone. During resolution, we noted a gradually increasing resistance index of the blood flow in the region of the gestation, but the tube became distended to 4.4 +/- 0.4 cm before gradually decreasing in size. No complications or side effects were encountered. These findings suggest that intratubal transvaginal methotrexate administration can provide a safe alternative to surgical treatment for patients with early unruptured tubal ectopic pregnancy. However, the presence of a living embryo makes the ectopic pregnancy more resistant to methotrexate treatment.
T Tulandi; P M Bret; M Atri; M Senterman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  77     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-04-18     Completed Date:  1991-04-18     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  627-30     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
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MeSH Terms
Chorionic Gonadotropin / blood
Methotrexate / administration & dosage,  therapeutic use*
Pregnancy, Tubal / blood,  drug therapy*
Reg. No./Substance:
0/Chorionic Gonadotropin; 59-05-2/Methotrexate

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