Single-dose methotrexate for the treatment of unruptured ectopic pregnancy

Abstract

In conclusion, this study showed that medical treatment of ectopic pregnancy with systemic single-dose methotrexate seems to be an option for some patients with unruptured tubal pregnancy.

Evaluation of Medical Treatment Success in Ectopic Pregnancy with Single Dose Methotrexate: 5 Year Experience

“…Through many studies, initial BHCG level, size of an ectopic gestational mass, the presence of fetal cardiac activity, the presence of free peritoneal fluid and the presence of pelvic pain or vaginal spotting have been accepted as predictors of success for single dose regimen 14,17 . BHCG level was one of the first variables found to be associated with successful treatment.…”

Evaluación del tratamiento médico del embarazo ectópico con metotrexato

“…Sin embargo, la morbimortalidad materna asociada al EE ha disminuido considerablemente gracias al diagnóstico precoz del mismo 2,5,7,9,10 . Un gran índice de sospecha clínico, junto a la combinación de los niveles séricos de ßHCG y el uso precoz de la ecografía transvaginal, ha permitido detectar y tratar el EE antes de que se produzca su rotura 4,6,8,9 , lo que ha supuesto un cambio radical en el tratamiento del mismo.…”

Protective effect of calcium folinate against methotrexate-induced endosalpinx damage in rats

“…Antifolate substances, represented by MTX, continue to occupy a unique and important niche among modern pharmacopoeia for patients with EP (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). MTX can inhibit normal trophoblasts and decrease cytotrophoblast differentiation and proliferation (4,30), and it can be used to treat EP effectively (1-3, 5-10).…”

“…A1-3 and B1-3 received MTX (1, 2, 5 mg/kg IP) accordingly, plus CF (0.1, 0.2, 0.5 mg/kg IP) for B1-3 24 hours after MTX injection. The range of MTX and CF (AnHui Pharmaceutical Factory, Hefei City, China) was chosen according to the literature (1,2,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)22). However, we designed a dynamic dose of CF applied in 10% of the MTX dose to evaluate its true capability to protect susceptible endosalpinx tissues.…”

“…Methotrexate (MTX) is a classical folate antagonist that has been used in the treatment of ectopic pregnancy (EP) for many years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Patients with EP can be successfully treated with MTX in various protocols and approaches (1)(2)(3)(5)(6)(7)(8)(9)(10).…”