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SECONDARY RESULTS OF METHOTREXATE TREATMENT IN TUBAL ECTOPIC PREGNANCY
Abstract
Ectopic pregnancy is a major cause of morbidity in reproductive age women. Surgical treatment was replaced recently by medical conservative treatment such as methotrexate therapy. Primary outcomes of conservative methotrexate treatment are evaluated through success and failure rates. We performed a retrospective study in two Obstetrics and Gynecology Clinic Hospitals in Bucharest (Gheorghe Polizu Hospital) and ConstanЕЈa in order to compare the efficacy of methotrexate single-dose (ConstanЕЈa) versus multi-doses (Bucharest). A total of 238 patients admitted in both hospitals (137 in Bucharest and 101 in ConstanЕЈa) were treated with methotrexate. The success rate for Bucharest was 78.84\%, while for ConstanЕЈa it was 76.23\%. Secondary outcomes of conservative Methotrexate are represented by tubal permeability, subsequent fertility and HCG's return to a normal value. The subsequent fertility in our study is represented by intrauterine pregnancies and extrauterine pregnancies in patients treated with Methrotexate 1,6 years ago. In Bucharest intrauterine pregnancy rate was 75\% and extrauterine pregnancy rate was 25\%. In Constantza intrauterine pregnancy rate was 66,7\% and extrauterine preganancy rate was 33,3. The subsequent fertility after Methotrexate treatment in tubal ectopic pregnancy is higher in Bucharest than in ConstanЕЈa, which suggests that multi-doses treatment is apparently superior to single dose treatment.
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