SINGLE INJECTION OF METHOTREXATE FOR TREATMENT OF ECTOPIC PREGNANCIES

OBJECTIVE: Our purpose was to evaluate the efficacy of single-dose met hotrexate as a treatment option for ectopic pregnancies. STUDY DESIGN: Patients were recruited from a tertiary teaching hospital setting. Th ey had (1) a gestational sac <3.5 cm, (2) no fetal cardiac activity an d (3) no significant pelvic pain or signs consistent with hemoperitone um. Patients excluded were those who did not desire future fertility o r who had evidence of renal or liver disease. Sixty-one patients meeti ng these criteria were selected and treated with a single intramuscula r injection of methotrexate at a dosage of 50 mg/m(2). RESULTS: Or the 61 patients treated, 16 required a second injection and nine required surgical intervention. Fifty-two (85%) were successfully treated as o utpatients with methotrexate alone. CONCLUSION: Nonsurgical treatment of ectopic pregnancies with single-dose methotrexate is an option for some patients, but more studies are needed to establish the safety, ef ficacy, and effect on fertility.