Methotrexate embryopathy in a surviving intrauterine fetus after presumed diagnosis of ectopic pregnancy: case report

Abstract

Case: A 30-year-old woman with a history of 6 spontaneous first trimester abortions and no living children, who had previously been treated for polycystic ovarian syndrome, was given methotrexate parenterally for a suspected ectopic pregnancy at 5 weeks of amenorrhea. Later, a surviving intrauterine pregnancy was noted, and the pregnancy continued. Her baby was delivered with multiple skeletal anomalies and ambiguous genitalia.

Conclusion: Physicians must discuss the teratogenicity of methotrexate with their patients before its administration. Careful clinical and ultrasound evaluations are recommended before the administration of methotrexate to avoid complications in pregnancy and adverse birth outcomes.