Suneela Kolluri
BACKGROUND Ectopic gestation though potentially life threating, timely diagnosis and appropriate treatment can reduce the risk of maternal mortality and morbidity. The benefits of medical therapy particularly with single dose methotrexate and the cure rate are high. The objective of the study was to explore the efficiency of medical management with single-dose methotrexate in unruptured ectopic gestation. MATERIALS AND METHODS Women with an ectopic pregnancy, meeting the criteria for medical treatment were included in the study. All the patients were hospitalized. The protocol was a single dose of methotrexate 50mg IM or 1 mg/kg body weight. All the patients were reviewed after 4 days. If the beta-HCG level drops by 15%, then the women were reviewed weekly until the HCG level falls to less than 5 IU/L. The 2nd dose was given if the HCG falls below 15% or if there is no drop. RESULTS The overall success rate of single-dose methotrexate was 64%. 2nd dose methotrexate was required in 11% of patients. In 25% of the cases, surgery was required. Laparoscopic procedure was done in 12% of cases and emergency laparotomy was performed in 13% of the cases. CONCLUSION Single-dose methotrexate therapy is effective in a selected group of patients.
