Abstract
Objectives:Ectopic pregnancy occurs when the embryo fails to implant within the uterine cavity.Methotrexate,a folic acid antagonist has been widely used to treat ectopic pregnancy.The aim of this study is to determine the efficacy of methotrexate treatment for ectopic pregnancies,which will in-turn help us reduce maternal mortality and morbidity.Methods:We studied 150 women with ectopic pregnancies who were treated with methotrexate.Selection criteria included hemodynamically stable women with B-hcg level of ≤5000 mIU/ml,adnexal mass ≤4 cm,absent cardiac activity and hemoperitoneum less than 100 ml.Pretreatment serum concentrations of human chorionic gonadotropin and progesterone,the size and volume of the gestational mass,and the presence of fluid (presumably blood) in the peritoneal cavity were correlated with the efficacy of therapy,as defined by resolution of the ectopic pregnancy without the need for surgical intervention.Results:There was no relation between the women's age or parity,the size or volume of the conceptus,or the presence of fluid in the peritoneal cavity and the efficacy of treatment.Analysis revealed the pretreatment serum chorionic gonadotropin concentration to be the only factor that contributed to the failure rate.Conclusions:Among women with ectopic pregnancies,a high serum chorionic gonadotropin concentration is the most important factor associated with failure of treatment with methotrexate protocol.
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