Efficacy of Systemic Methotrexate in Unruptured Tubal Pregnancy

Abstract

Objective: To observe the efficacy of systemic methotrexate for the treatment of unruptured
tubal pregnancy.
Material and Methods: It was a descriptive study carried out over a period of 6 months from 01-
10-2012 to 31-03-2013 in the department of obstetrics and gynaecology unit III, Services
Hospital, Lahore. A total of 65 cases were included in this study. Patients were given single dose
2 th th
of injection methotrexate 50mg/m intramuscularly andb - hCG level was assessed at 4 and 7th
day for each patient. In those patients in which b - hCG level did not fall more than 15% on day 4
th
and 7 were surgically treated by doing laparotomy.
Results: Among 65 patients, age distribution showed 7 patients (10.8%) were less than 20 years
of age, 41 patients (63%) were between 20 -30 years and 17 patients (26.2%) were between 30-
40 years of age. Mean age was 29.7±4.9 years. According to distribution of parity, 17 women
(26.2%) were primigravida, 38 women (58.4%) were para 2-4 while 10 women were para 5-7. Out
of65 women, 11 (16.9%) presented at <6 weeks of gestation and 54 (83.1%) at 6-8 weeks of
gestational age. Mean gestational age was 6.7±1.9 weeks. Efficacy of methotrexate for the
treatment of unruptured tubal pregnancy observed in 44 women (67.7%) in term of fall in -hCGb
level > 15%.
Conclusion: Methotrexate is an effective medical management for ectopic pregnancies in a
society where tubal conservation is of utmost importance.