Ectopic pregnancy: Methotrexate therapy
- Togas Tulandi, MD, MHCM
Togas Tulandi, MD, MHCM
- Professor of Obstetrics and Gynecology
- Milton Leong Chair in Reproductive Medicine
- McGill University, Canada
An ectopic pregnancy is a pregnancy outside of the uterine cavity. Almost all ectopic pregnancies occur in the fallopian tube (98 percent) , 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 . 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: Incidence, risk factors, and pathology")
●Clinical manifestations and diagnosis (see "Ectopic pregnancy: Clinical manifestations and diagnosis")To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CLINICAL PHARMACOLOGY
- Route of administration
- Adverse reactions
- CLINICAL PROTOCOL
- Pretreatment testing
- Efficacy of single versus multi-dose therapy
- - Single-dose protocol
- - Multiple-dose protocol
- Precautions during therapy
- Pain after treatment
- SUBSEQUENT PREGNANCY
- Interval to conception
- Obstetric outcome
- INTERSTITIAL PREGNANCY
- NONTUBAL ECTOPIC PREGNANCY
- COMBINED USE WITH OTHER MEDICATIONS
- Other agents
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS