Comparison of Single-Dose and Multiple-Dose Systemic Methotrexate Regimen for Ectopic Pregnancy

Document Type : مقاله کوتاه

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Associate Professor, Department of Obstetrics and Gynecology, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Resident, Department of Obstetrics and Gynecology, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Researcher, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

Background: Ectopic pregnancy is a common serious problem with high morbidity percentage and possibility of maternal mortality. Methotrexate, in the patients with unruptured less-than-4-cm ectopic mass, is a proved treatment. We compared single- and multiple-dose systemic methotrexate regimen for ectopic pregnancy.Methods: 120 women who were diagnosed to have ectopic pregnancy via clinical symptoms, ultrasound examination and beta human chorionic gonadotropin (β-hCG) levels were divided to two equal groups. The first were treated with a single dose regimen of intramuscular methotrexate (50 mg/m2) and the second, received 4 doses of 1 mg/kg of intramuscular methotrexate at the days 1, 3, 5, and 7. The serum β-hCG values were measured and compared at the initiation of treatment and 1 week and 1 month after it.Findings: The overall success rate of methotrexate for an ectopic pregnancy was 76% in single-dose and 96.7% in multiple-dose regimens. The rupture of ectopic pregnancy mass during the treatment was less (3.3%) in multiple-dose group compared to the single-dose one (10%).Conclusion: Multiple-dose methotrexate therapy is more effective than single-dose in ectopic pregnancy and is safer, too.

Keywords


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