Results and related factors of treatment of ectopic tubal pregnancy with methotrexate

Document Type : Original Article


1 Associate professor, Department of Obstetrics and Gynecology, Maternity Research Center, School of Medicine, Kermanshah University of medical sciences, Kermanshah, Iran.

2 M.Sc. Student of Counseling in Midwifery, School of Nursing and Midwifery, Kermanshah University of Medical Science, Kermanshah, Iran.

3 Associate professor, Department of Biostatistics and Epidemiology, Health Promotion and Social Development Research Center, School of Health, Kermanshah University of medical sciences, Kermanshah, Iran.

4 General practitioner, School of Medicine, Kermanshah University of medical sciences, Kermanshah, Iran


Introduction: Tubal ectopic pregnancy is a common reason of death caused by pregnancy at third trimester. Methotrexate (MTX) is one of the common medical treatments in ectopic pregnancy (EP). This study was performed with aim to evaluate the result of treatment with multiple dose of MTX.
Methods: This descriptive-analytic study was performed on 262 women with ectopic pregnancy who were treated with multiple dose MTX therapy in Imam Reza educating and treatment center in Kermanshah during 2008-2012. The findings related to initial β-hCG level, ectopic mass size, gestational age, the presence of the yolk sac, the need for surgical intervention, presence or absence of free fluid in the culdesac in ultrasound and gestational age were extracted from medical records of the patients and were recorded in the checklist. Data was analyzed by SPSS software (version 20), and Chi-square test. PResults: Mean age of the patients was 29.11±4.87 years that most of them were gravid 1 and 2. Mean age of the patients, gestational age, gravidity and parity were not effective in the success rate of multiple dose methotrexate therapy (P>0.05). The success rate of multiple dose methotrexate therapy was 80.5%. There was relationship between response to therapy and mean β-hCG level.
Conclusion: Regarding to high success rate of medical therapy with multiple dose methotrexate, it can be considered as an effective treatment option for patients with irrupted tubal EP. Also, attention to initial level of β-hCG is recommended in selection of patients for medical therapy in orde to reduce failure rate.


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