Document Detail

A systematic review of single-dose intramuscular methotrexate for the treatment of ectopic pregnancy.
MedLine Citation:
PMID:  9653847     Owner:  NLM     Status:  MEDLINE    
The use of single-dose intramuscular methotrexate for the primary treatment of ectopic pregnancy is increasing in frequency in many countries. We performed a systematic review of all available studies and case reports of intramuscular methotrexate to examine the therapeutic efficacy, side-effects and complication rates of this new treatment approach. The pooled data show a successful resolution rate of 71% (95% confidence interval 58% to 81%) after a single dose of intramuscular methotrexate and 84% (95% confidence interval 77% to 90%) after 1 or 2 doses. Side-effects were experienced by 24% (95% confidence interval 9% to 47%) of patients and 10% (95% confidence interval 7% to 14%) had a ruptured ectopic pregnancy. The pooled data show that single-dose intramuscular methotrexate is associated with a high failure rate. Follow-up is prolonged and there is a significant incidence of minor side-effects. Serious complications and side-effects have occurred. The use of intramuscular methotrexate should be confined to clinical trials until more evidence is obtained to support its more widespread use.
J Parker; A Bisits; A M Proietto
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  38     ISSN:  0004-8666     ISO Abbreviation:  Aust N Z J Obstet Gynaecol     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-09-28     Completed Date:  1998-09-28     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  145-50     Citation Subset:  IM    
Division of Obstetrics and Gynaecology, John Hunter Hospital, Newcastle, New South Wales.
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MeSH Terms
Drug Administration Schedule
Injections, Intramuscular
Methotrexate / administration & dosage*,  adverse effects
Pregnancy, Ectopic / drug therapy*,  mortality
Pregnancy, Tubal / drug therapy,  mortality
Risk Factors
Rupture, Spontaneous
Survival Analysis
Treatment Failure
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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