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Re: Gyn: Abnormal pregnancyFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Mon Nov 22 04:51:46 2004
At Mon, 22 Nov 2004, Elrod Darryl G MAJ 48 MDOS/SGOBO wrote: > >Only so that you don't treat an incomplete with MTX. > >R. Daniel Braun, MD > >What would be the harm in giving MTX to an incomplete (other than a >waste of time and money)? > >Glen - almost little harm if you are 100% certain it is an incomplete or missed,but if this is the 1:100 case where B HCG is rising slower than expected in a early intrauterine pregnancy then you may be looking at at pregnancy with a baby that has some serious anamolies secondary to the MTX. -if your pharmacy mixes MTX for ectopics frequently then its probably safe, if not then there is always a chance they get the chemo dose instead of the ectopic dose, personally I would not trust my pharmacy to do anything out of there routine despensing. Not necessarrily a fatal mistake but you have to worry about folic acid rescue, serious side effects etc. -Mtx came into vogue for treating arthritis and even asthama, the long term reprecusions for this are not known. I have two patients who developed carcinoma in situ of the cervix in there 50's, both where on MTX for arthritis. Yes pretty crapy Data, but guess what that's how the link between clear cell ca and DES got started.
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Take care, John
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