Sa. Mesogitis et al., LOCAL APPLICATION OF METHOTREXATE FOR ECTOPIC PREGNANCY WITH A PERCUTANEOUS PUNCTURING TECHNIQUE, Gynecologic and obstetric investigation, 45(3), 1998, pp. 154-158
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.