A Clinical Analysis of Unruptured Ectopic Pregnancies with the Treatment of Intramuscular Methotrexate Injiction

Choi, Gyu Hong; Jung, Hoo Yeon; Ryu, Ryok Ho; Huh, Kyung Sun

Abstract

The incidence of ectopic pregnancy is a marked increase in both the absolute number and rate in recent years. But dramatic decrease in death from ectopic pregnancies probably due to improved diagnosis and management. The aim of the study was to investigate the effect of intramuscular Methotrexate(MTX) injection on the treatment of ectopic pregnancy. The method of the study was made by the retrospective clinical observations on the 32 cases of unruptured ectopic pregnancies in Chung Goo Sung Sim hospital, department of Obstetrics & Gynecology. The results were as follows: 1) The most frequent age group was 25-29 year group(37.5%). 2) Nullipara was 31.3% and the case who experienced artificial abortion was 75%. 3) A previous history of abdominal or pelvic surgery was in 40.6% and pelvic inflammatory in 6.3%. 4) The mean ectopic gestational week was 6.4 weeks, 5) On symptomatological analysis, lower abdominal pain was encounted 53.1%, vaginal spotting was 40.6%. 6) The resolution of patients was obtained in 29 cases(90.6%)of 32 unruptured tubal pregnancies with intramuscular methotrexate treatment. 7) The mean resolution duration was 23.8 days. 8) The side effects of methotrexate were observed in 10 cases(31.2%)of 32 unruptured tubal pregnancies, but the severity of symptoms was mild. Consequently, tveatment by intramuscular injection of MTX expects to be one of the therapies alternating to surgery. However success rate remained 90.6% with and toxicity rate 31.2% with MTX injection. Therefore patients selection criteria and MTX dosage adjustment are more stricdy required for rising success rate and avoidance of toxic complication.