COMBINED CHEMOTHERAPY IN THE MEDICAL-MANAGEMENT OF TUBAL PREGNANCY

The medical management of early unruptured tubal ectopic pregnancies i s gaining acceptance internationally as an alternative to surgical pro cedures; This method has been shown to be effective and safe in proper ly selected cases and with adequate supervision. Most of the work howe ver has been done using tither methotrexate or prostaglandins. The pre sent study aimed to evaluate the efficacy df a combined therapeutic re gimen. The efficacy was noted to be at least as good but with fewer si de-effects. The treatment was effective in 18 out of 19 cases of tubal pregnancies (94.7%). One patient complained of a gastritis which reso lved with antacids. One patient experienced abdominal cramps and trans ient hypotension probably as a profound vagal response during tubal ab ortion. The median time to resolution varied directly with the initial serum beta HCC level at diagnosis. All patients who responded to the therapy described the experience as painless and viewed the treatment positively as it spared them the need for surgery and its attendant an aesthetic risks. However, we strongly recommend caution and close supe rvision arid to keep the patient in the hospital at least for the firs t week of therapy.