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Clinical Trial
. 1995 Jan;63(1):25-9.

Ultrasound-guided injection of methotrexate versus laparoscopic salpingotomy in ectopic pregnancy

H Fernandez  1 , S Pauthier, S Doumerc, C Lelaidier, F Olivennes, Y Ville, R Frydman
Affiliations
  • PMID: 7805919
Free article
Clinical Trial

Ultrasound-guided injection of methotrexate versus laparoscopic salpingotomy in ectopic pregnancy

H Fernandez et al. Fertil Steril. 1995 Jan.
Free article

Abstract

Objective: To compare local injection of methotrexate (MTX) under sonographic control to laparoscopic salpingotomy for conservative management of ectopic pregnancy (EP).

Design: Prospective randomized study.

Patients: Forty patients were randomized into two groups using a random number table. Inclusion criteria were an EP visualized by ultrasound with a pretherapeutic score < or = 13 as assessed by six criteria graded from 1 to 3: gestational age, hCG level, P level, abdominal pain, volume of the hemoperitoneum, and diameter of the hematosalpinx.

Interventions: Group 1 patients injected transvaginally with 1 mg/kg MTX into the EP without anesthesia versus group 2 patients undergoing laparoscopic salpingotomy.

Main outcome measures: Postoperative hospital stay, decrease of hCG levels, success rate.

Results: The success rates, defined by hCG levels returned to normal (< 10 mIU/mL [conversion factor to SI units, 1.00]), were 19 of 20 in both groups. Medical treatment was associated significantly with shorter postoperative stay (24 versus 46 hours) and a higher initial hCG level. Human chorionic gonadotropin returned to normal more quickly after laparoscopic treatment (14 versus 28 days).

Conclusions: In selected cases of EP with a pretherapeutic score < or = 13, MTX treatment appeared to be as safe and efficient as was conservative treatment by laparoscopy.

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