ROLE OF INJECTION METHOTREXATE IN THE MANAGEMENT OF ECTOPIC PREGNANCY

Abstract

Objective: To evaluate the success rate of injection ‘methotrexate’ in the management of ectopic pregnancy.

Study Design: A single group interventional study.

Place and Duration of Study: NESCOM Hospital Islamabad, from Jan 2014 to Dec 2017.

Methodology: All patients admitted with ectopic pregnancy fulfilling the inclusion criteria i.e, a stable clinical condition, no evidence of rupture on ultrasound, normal liver and renal functions were included in the study, while the patients who were showing signs of rupture ectopic or with abnormal liver and renal functions were excluded from the study. Data was collected on predesigned performa. Diagnostic tools were Transvaginal Sonography and serial serum β-human chorionic gonadotropin levels .These patients were treated with injection methotrexate 50 mg/kg body weight. Serum β-human chorionic gonadotropin levels were done on day 4 and day 7 and weekly thereafter till ≤5 mIU/ml.

Results: The total number of patients (88) with 18-39 years, fulfilling the inclusion criteria were given injection methotrexate. Medical treatment was successful in 81.8% of patients whereas failure was observed in 18.2%. Among which 67 patients were given single dose, 20 patients received 2 doses and only 01 patient needed 3 doses. The mean resolution time for β-human chorionic gonadotropin level was 21 days (11-58). Average resolution time for adnexal masses (<3cm) was 19 days and for adnexal masses (>3cm) was 39 days.

Conclusion: Methotrexate was found to be safe, cost effective and fertility preserving alternative to the surgical management of ectopic pregnancy.