M Lesavre1, S Curinier2, P Capmas3, B Rabischong2, H Fernandez3. 1. Service de gynécologie-obstétrique, CHU Bicêtre, 78, avenue du général-Leclerc, 94276 Le Kremlin-Bicêtre, France. Electronic address: magali.lesavre@bct.aphp.fr. 2. Service de gynécologie-obstétrique, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont Ferrand, France. 3. Service de gynécologie-obstétrique, CHU Bicêtre, 78, avenue du général-Leclerc, 94276 Le Kremlin-Bicêtre, France.
Abstract
OBJECTIVES: To make a literature analyse about methotrexate as a treatment of tubal ectopic pregnancy. MATERIALS AND METHODS: We made a PubMed research and found articles, randomized control studies, systematic revues and meta-analyses of the Cochrane Database about ectopic pregnancies treated by methotrexate. We made a summary of these articles. RESULTS: Methotrexate can be used as a treatment of tubal ectopic pregnancy with hCG<5000 UI/L and expectative is an option if hCG level is lower than 1500 UI/L. Medical treatment by methotrexate seems to be less effective than surgical salpingotomy but the rate of recurrence and the rate of intra-uterine pregnancy are similar regardless of the treatment chosen. Fertility seems to be the same after treatment by methotrexate. Economically, methotrexate is less expensive than the surgical management (laparoscopy). CONCLUSION: Methotrexate can be used as a treatment of tubal ectopic pregnancies if every criterions of safety are gathered.
OBJECTIVES: To make a literature analyse about methotrexate as a treatment of tubal ectopic pregnancy. MATERIALS AND METHODS: We made a PubMed research and found articles, randomized control studies, systematic revues and meta-analyses of the Cochrane Database about ectopic pregnancies treated by methotrexate. We made a summary of these articles. RESULTS:Methotrexate can be used as a treatment of tubal ectopic pregnancy with hCG<5000 UI/L and expectative is an option if hCG level is lower than 1500 UI/L. Medical treatment by methotrexate seems to be less effective than surgical salpingotomy but the rate of recurrence and the rate of intra-uterine pregnancy are similar regardless of the treatment chosen. Fertility seems to be the same after treatment by methotrexate. Economically, methotrexate is less expensive than the surgical management (laparoscopy). CONCLUSION:Methotrexate can be used as a treatment of tubal ectopic pregnancies if every criterions of safety are gathered.