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  • Title: Management of tubal pregnancy with methotrexate.
    Author: Zakut H, Sadan O, Katz A, Dreval D, Bernstein D.
    Journal: Br J Obstet Gynaecol; 1989 Jun; 96(6):725-8. PubMed ID: 2478186.
    Abstract:
    Ten women with tubal ectopic pregnancy were treated by the injection of methotrexate into the gestational sac under direct laparoscopic vision followed by a course of intramuscular therapy including folinic acid rescue. One course of treatment induced resolution of the extrauterine pregnancy in eight women. Complete resolution (beta-hCG less than 10 miu/ml) was achieved within 6-47 days (mean 14.5 days). Serum beta-hCG levels started to decline 3.4 days from the beginning of therapy. Length of hospital stay was 5-11 days (mean 6.4 days). Treatment failed in two patients. One woman had a laparoscopic tubal clip sterilization concomitantly with methotrexate treatment. Tubal patency was demonstrated in all the other seven women (100%) tested subsequently. There is a need to establish criteria for patient selection before methotrexate becomes a routine treatment for tubal pregnancy. 10 women with tubal ectopic pregnancy were treated with injections of methotrexate into the gestational sac under direct laparoscopic vision followed by a course of intramuscular therapy including folinic acid rescue. 1 course of treatment induced resolution of the extrauterine pregnancy in 8 women. Complete resolution (beta-HCG 10 miu/m1) was achieved within 6-47 days (mean 14.5 days). Serum beta-HCG levels started to decline 3-4 days from the beginning of therapy. The length of hospital stay was 5-11 days (mean 6.4 days). Treatment failed in 2 patients. 1 woman had a laparoscopic tubal clip sterilization concomitantly with the methotrexate treatment. Tubal patency was demonstrated in the other 7 women (100%) tested subsequently. There is a need to establish criteria for patient selection before methotrexate becomes a routine treatment for tubal pregnancy.
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