LOCAL APPLICATION OF METHOTREXATE FOR ECTOPIC PREGNANCY WITH A PERCUTANEOUS PUNCTURING TECHNIQUE

Management of ectopic pregnancy remains traditionally surgical. Early detection of unruptured ectopic pregnancies, using both ultrasound tec hniques and beta-human chorionic gonadotropin (beta-hCG) assays, allow s a more conservative treatment, Twenty-six tubal pregnancies, which w ere managed with local methotrexate (MTX) injection, are presented. A single dose of 10-12.5 mg of MTX was percutaneously injected into the gestational sac under abdominal sonographic control. Complete resoluti on was obtained in all our patients, Four of them required a second pe rcutaneous administration 4 days after the first one. Negligible serum beta-hCG levels (<10 mIU/ml) were reached within 42 days after treatm ent. No systemic side effects were observed. Local administration of M TX under abdominal sonographic control seems to be an effective altern ative for the treatment of ectopic pregnancy. The main potential advan tages of the method are (1) a greater antitrophoblastic effect; (2) a shorter treatment period; (3) reduced dosage, and (4) absence of side effects.