An economic evaluation of single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured ectopic pregnancy

Outcome of Methotrexate Management in Tubal Ectopic Pregnancy: A Retrospective Study in Women's Hospital in Qatar

“…Moreover, the cost between MTX therapy and laparoscopic surgery in patients with bhCG below 1500 IU/L is comparable. 12 Since, the cost is not an issue to the patient in our institution (because it is a public run service), few patients with relative contraindications opted for MTX management to avoid survey and to preserve future pregnancy. We found higher number of patients who received high dose MTX end up with surgery.…”

MTX Could Be First-Line Therapy Even in Cases Where hCG Level is Greater than 5,000 IU/ml

“…E f f o r t s h o u l d b e m a d e t o c o n f i r m t h e d i a g n o s i s o f e c t o p i c pregnancy definitively before starting MTX treatment; otherwise, complication rates or costs could rise on the contrary. Seror et al reported that MTX treatment appeared to be costeffective in EP cases where the preservation of fertility was important (10). About 40% of women with ectopic pregnancy are treated medically (11), and 90% of them are successfully treated without any surgical intervention at all (12).…”

“…Seror reported that, although frequent diagnostic ultrasound is necessary, MTX is cost-effective compared with surgical intervention (10). However, subsequent pregnancies should be followed with extreme caution, and elective cesarean section should be considered as an alternative.…”

Clinical Treatment of Unruptured Ectopic Pregnancy

“…Systemic MTX in a single-dose regimen compared with laparoscopic salpingostomy of four trials (Fernandez et al, 1998;Saraj et al, 1998;Sowter et al, 2001;El-Sherbiny et al, 2003), involving 265 haemodynamically stable women with a small unruptured tubal EP, showed no significant differences in the number of IUPs (RR 1.01, 95% CI 0.66-1.54), whereas there was a non-significant trend towards a lower incidence of repeat EPs (RR 0.63, 95% CI 0.14-2.77) (Mol et al, 2008). Systemic MTX in a fixed multiple dose regimen compared with laparoscopic salpingostomy observed that fertility outcome was no significant different for IUP (RR 0.88, 95% CI 0.49-1.60) as well as for repeat EP (RR 0.88, 95% CI 0.21-3.67) (Dias Pereira et al, 1999).…”