ABSTRACT
Objective: to determine success rate in medically managed ectopic pregnancies with Injection Methotrexate.
Setting and Duration: this case series study was conducted from May 2012-Mar 2013 in Maternal and Child Care Centre, Pakistan Institute of Medical Sciences, Islamabad.
Methodology: this study included 57 patients with ectopic pregnancy (EP). Ultrasound was performed for confirmation of ectopic pregnancy. Serum beta hCG levels were determined at the time of presentation and then at day 4 and day 7. Systemic methotrexate at the dose of 1mg/kg body weight was administered. A second dose was given to those cases in which more than 10 – 15% fall of beta-hCG level did not occur after day 4. The outcome of interest was success rate.
Results: the mean age of the patients was 28.79 ± 5.06 years. The mean beta hCG levels in the study sample at day 1, 3, 5 and 7 were 3149 ± 978.49 mIU/ml, 2108 ± 1195.76 mIU/ml, 1101.96 ± 1246.79mIU/ml and 16.25 ± 31.33 mIU/ml respectively. There were 44 (77.2%) patients who were treated with a single dose of methotrexate, while in 13 (22.8%) patients, two doses were needed. There were 48 (84.2%) patients in whom the treatment remained successful, and the failure of the treatment was seen among 9 (15.8%) patients, who were managed with surgery.
Conclusions: the success rate of treatment of ectopic pregnancy with Methotrexate is high hence, it should be considered as first line therapy among patients with ectopic pregnancy.
Key Words: ectopic pregnancy, Success, Methotrexate.

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