[Medical treatment of ectopic pregnancies with methotrexate. Retrospective study and literature review].

Abstract

Ectopic pregnancy (EP) affects 1-2 % of all pregnancies and is a significant risk of maternal morbidity and mortality. Treatment with methotrexate (MTX) is well established. However, certain aspects, such as the acceptable serum hCG threshold for considering medical treatment or the usefulness of predictive scores to guide therapeutic decisions, remain controversial. The aim of this multicenter retrospective study was to evaluate the efficacy of MTX in the treatment of EPs at the Gynaecology Department in Liège and the impact of two predictive scores. Of 256 patients included, 206 (80.5 %) were successfully treated with MTX alone. Three predictive factors for success were identified: the type of EP, an initial hCG level below 1500 IU/L and the absence of fetal cardiac activity. The use of these two scores in this cohort did not significantly improve the success rate.