ASSESSMENT OF METHOTREXATE’S EFFICACY IN THE TREATMENT OF UN-RUPTURED ECTOPIC PREGNANCY

Shahida Sultan; Samina A Sabir

doi:10.46903/gjms/21.04.1346

ASSESSMENT OF METHOTREXATE’S EFFICACY IN THE TREATMENT OF UN-RUPTURED ECTOPIC PREGNANCY

Shahida Sultan, Samina A Sabir

Abstract

Background: Methotrexate has emerged as a promising alternative to surgical intervention for unruptured ectopic pregnancy. The aim of this study was to assess the effectiveness of methotrexate as a treatment option for unruptured ectopic pregnancy.

Materials & Methods: This descriptive study focused on women who were diagnosed with unruptured ectopic pregnancy and received methotrexate treatment at Lady Reading Hospital Peshawar between January 2021 and December 2022. Inclusion criteria were positive pregnancy test, abdominal pain, vaginal bleeding, stable hemodynamics, serum beta-human chorionic gonadotropin (BHCG) levels below 3000 IU/L, and transvaginal ultrasound (TVS) findings of an adnexal mass below 3cm without cardiac activity. Exclusion criteria were false pregnancy test results, BHCG levels exceeding 3000 IU/L, ruptured ectopic pregnancy, hemodynamic instability, shock, and sepsis. Data analysis was performed using SPSS v26.

Results: Total 63 patients were enrolled in this study, and overall success rate of methotrexate treatment for unruptured ectopic pregnancy was determined to be 88.88%. Also 77.77% of cases achieved complete recovery without any complications. Single-dose methotrexate was administered to 49 patients (77.77%), while 14 patients (22.22%) required multiple doses. Seven patients (11.11%) experienced tubal rupture, and an equal number of patients (11.11%) had tubal abortion. In terms of symptom resolution, 48% of patients experienced complete resolution within 14 days. Furthermore, 41% of patients reported symptom resolution within 7 days, with a smaller percentage of 11% achieving resolution within 4 days.

Conclusion: In this study the overall success rate was 88.88% and a majority of patients experiencing symptom resolution within 14 days. The study highlights the well-tolerated nature of methotrexate treatment, emphasizing its potential as a non-surgical alternative.

Keywords

Methotrexate; Unruptured ectopic pregnancy; Safety; Efficacy; Success rate; Symptom resolution; Non-surgical treatment; Fertility preservation; Surgical risks.

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DOI: https://doi.org/10.46903/gjms/21.04.1346