Author(s): Stovall TG, Ling FW
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Abstract OBJECTIVE: Our purpose was to report an expanded clinical trial with a nonlaparoscopic approach to ectopic pregnancy diagnosis combined with single-dose intramuscular methotrexate treatment. STUDY DESIGN: A prospective cohort of 120 women with an ectopic pregnancy < or = 3.5 cm in greatest dimension was enrolled. RESULTS: Patients had a mean age of 26.1 +/- 6.2 years, a mean gravidity of 3.2 +/- 1.6, and a mean parity of 0.97 +/- 1.0. The mean human chorionic gonadotropin titer before treatment initiation was 3950 +/- 1193 mIU/ml. Transvaginal ultrasonography visualized cardiac activity in 14 (11.7\%) patients, with an ectopic mass visualized in 113 (94.2\%). The mean time to resolution in the 113 (94.2\%) subjects successfully treated was 35.5 +/- 11.8 days. Four (3.3\%) patients required a second methotrexate dose on day 7. No biochemical or clinical side effects occurred. Posttreatment hysterosalpingograms demonstrated tubal patency on the ipsilateral side in 51 of 62 (82.3\%) patients. Of those attempting pregnancy, 79.6\% were pregnant, 87.2\% intrauterine and 12.8\% ectopic. The mean time to achieve pregnancy was 3.2 +/- 1.1 months. CONCLUSIONS: This regimen requires minimal laboratory follow-up and eliminates leukovorin recovery, making it the regimen of choice for medical treatment of unruptured ectopic pregnancy.
This article was published in Am J Obstet Gynecol
and referenced in Journal of Clinical Case Reports