A study on medical management of ectopic pregnancy using methotrexate

Ectopic pregnancy is defined as one where fertilised ovum implants outside the normal uterine cavity the main sites for implantation include tubes, ovaries, cervix, rudimentary horn of a bicornuate uterus and cesarean scar. Risk factors being PID tuberculosis of pelvis, use of progesterone contraception, endometriosis of tube, congenital anomalies of tube. Diagnosis is being made by TVS and serum beta HCG. Treatment depends on hemodynamic stability of patient. In unstable patients surgical management is best but in stable patients medical management with methotrexate is done. Our study is aimed at medical management of ectopic. Methodology and results: 70 unruptured ectopic patients were included in study. 12 patients were kept for observation. 58 patients were selected for medical management i.e. methotrexate treatment. No. Of patients with Successful single dose methotrexate treatment were 42 (72.4%) No. Of patients required multidose methotrexate were 10(17.24%) No. Of patients with failed methotrexate treatment and requiring surgical intervention were 2(3.4%) No. Of patients with tubal rupture 4(6.8%). Conclusion: Medical management of patients with ectopic pregnancy who are hemodynamic stability with methotrexate offers promising results and avoids surgical morbidity and offers a good obstetric future to the patients.