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Ectopic pregnancy: Methotrexate therapy

Togas Tulandi, MD, MHCM
Section Editor
Courtney A Schreiber, MD, MPH
Deputy Editor
Sandy J Falk, MD, FACOG


An ectopic pregnancy is a pregnancy outside of the uterine cavity. The majority of ectopic pregnancies occur in the fallopian tube (84 percent) [1], but other possible sites include cervical, interstitial (also referred to as cornual; a pregnancy located in the proximal segment of the fallopian tube that is embedded within the muscular wall of the uterus), hysterotomy scar (eg, in a women with a previous cesarean delivery), intramural, ovarian, or abdominal. In addition, in rare cases, a multiple gestation may be heterotopic (include both a uterine and extrauterine pregnancy).

Ectopic pregnancy is a potentially life-threatening condition. While surgical approaches are the mainstay of treatment, many women are candidates for medical therapy with methotrexate because of advances in early diagnosis [2]. The overall success rate of medical treatment in properly selected women is nearly 90 percent [3,4].

Treatment of ectopic pregnancy with methotrexate (MTX) will be reviewed here. The surgical treatment of ectopic pregnancy is reviewed elsewhere (see "Ectopic pregnancy: Surgical treatment"). Related topics regarding ectopic pregnancy are discussed in detail separately, including:

Epidemiology, risk factors, and pathology (see "Ectopic pregnancy: Epidemiology, risk factors, and anatomic sites")

Clinical manifestations and diagnosis (see "Ectopic pregnancy: Clinical manifestations and diagnosis")

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Literature review current through: Nov 2017. | This topic last updated: Aug 30, 2017.
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