Outcome of Methotrexate Therapy in The Management of Undisturbed Tubal Ectopic Pregnancy

Gharib, Mahmoud Ahmed; Mohamed, Mohamed Lotfy; El-Nagar, Walid Mohamed; El-sayed, Amira

doi:10.21608/zumj.2020.21948.1690

Outcome of Methotrexate Therapy in The Management of Undisturbed Tubal Ectopic Pregnancy

Document Type : Original Article

Authors

¹ Department of Obstetrics and Gynecology, Faculty of Medicine ,Zagazig University, Zagazig, Egypt

² obstetric and gynecology department,faculty of medicine ,zagazig university Zagazig ,Egypt

³ Obstetric and gynecology department,faculty of medicine, zagazig university zagazig , Egypt

10.21608/zumj.2020.21948.1690

Abstract

Abstract
Abstract
Background: Ectopic pregnancy (EP) is implantation of the fertilized egg 5 outside endometrial cavity of uterus. Diagnosis of an ectopic pregnancy is vital , 6 as it can save mother’s life before tubal rupture takes place . Tubal rupture accounts 7 for 6% of deaths related to pregnancy . Ectopic pregnancy is treated either by 8 expectant management , methotrexate or surgical treatment. Objectives: in this study 9 we assess the association between using of Methotrexate and cure of undisturbed 10 tubal ectopic pregnancy .Methods: a clinical trial was performed on 16 patients with 11 undisturbed tubal ectopic pregnancy . Patients are given I.M methotrexate by a 12 dose of 1 mg/kg or Body Surface Area (BSA) dose based of 50mg/m2 and follow 13 up of the outcome either cure , laparoscopy or laparotomy. Results: There are 14 statistically non-significant differences between responder and non-responder 15 regarding age , BMI, gravidity, mass position, parity, history of abortion, gestational 16 age and mode of delivery .Alsowe found that by the end of the first week after 17 methotrexate intake, the decline in β-hCG was statistically significant among 18 responders (p value =0.001) while non-responders show non-significant change(p 19 value = 0.120 ).we also found that 11patients respond to methotrexate therapy 20 (68.7% ) while the remaining 5 patients were non responders .Conclusion: We 21 concluded that Methotrexate is an effective medical management for an ectopic 22 pregnancy especially when conservation of fallopian tube is needed .

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