Outcome of methotrexate management in tubal ectopic pregnancy: A retrospective study in women’s hospital in Qatar

Abstract

Objective: Ectopic pregnancy case fatalities have decreased dramatically, although incidence has remained steady over years. Advancement in early diagnosis methods and introduction of methotrexate (MTX) in the management has led to such improve ment. Different protocols, such as single, two dose and multiple doses of MTX has been indorsed by the American congress of obstetrics and gynecology. Here at Women’s Hospital in Qatar we use single dose pro tocol. However, there no previous report on the outcome of MTX in term success rate in Qatar. Methods: A retrospective study on patients diagnosed with tubal ectopic pregnancy between Jan 2008 and Dec 2010 were conducted. Institutional review board of Hamad Medical Corporation, Qatar, approved this study. Statistical analysis were done using SPSS Inc. Ver 20, Chicago, IL. Results: Two hundred and forty-eight file met the study inclusion and exclusion criteria, but only 196 completed their followup until beta-human chorionic gonadotropin (β-hCG) less than 15 IU/L. Methotrexate prescribing has increased three times over the study period. The success rate for MTX was 89% and it was positively correlated with lower initial b-hCG levels. However, six out six patients with in b-hCG levels more than 10,000 IU/L were successfully treated with MTX. Conclusion: Methotrexate is effective method of treatment in stable patients. Further studies are required to investigate role of MTX in patients with high b-hCG levels (> 10,000 IU/L).