The use of methotrexate for tubal ectopic pregnancy

Abstract

Introduction. Ectopic pregnancy is a severe gynecological emergency, which can be fatal in case of not having a correctly and quickly established diagnosis, as well as an appropriate intervention. According to the data of literature, the incidence of ectopic pregnancy has significantly increased over the last 20 years, it ranks the top in the structure of the acute gynecological diseases, constituting about 47%. Approximately 95-96% of ectopic pregnancy are implanted in different segments of the fallopian tubes (ampullary, isthmus, pavilion, interstitial) and more frequently in the ampullary portion. Results. Methotrexate is the first drug that was prescribed for the treatment of tubal ectopic pregnancy without surgery. It is still the mostly used today. Medicinal treatment with methotrexate is indicated to the patients with uncomplicated ectopic pregnancy, hemodynamically stable, with an initial level of β-HGC <5000 IU / L, inactivity of fetal heart, the diameter of the fetal egg of <3.5 cm and having minimal symptoms.About 35% of women with ectopic pregnancy will meet the criteria for a medicinal treatment. For these women, the treatment with variable-dose of methotrexate therapy is as effective as laparoscopic salpingectomy. Conclusions.Medical treatment with methotrexate is of less efficacy than surgical treatment, but its low cost and good effect on life quality in patients, makes it a good therapeutic option in treatment of tubal ectopic pregnancy. Although the frequency of ectopic pregnancy has increased in the last 20 years, due of modern and affordable methods of diagnosis and treatment mortality has decreased.