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Re: ectopic pregnancies and IM methotrexateFrom: Peter Wein (p.wein@obsgyn-mercy.unimelb.EDU.AU)Thu Dec 24 00:21:03 1998
At 00:43 24/12/98 -0600, you wrote: >I use Methotrexate but would not use it in a symptomatic woman or a >woman with an extopic of 4cm or more such as that you describe. The >only reason is that I haven't seen evidence to date that says it is >safe. I am keeping an eye out though as I have had great success with >methotrexate to date. > I am surprised that you do Tom - the pooled data show that methotrexate is associated with a failure rate (subsequent rupture) of 10%, as well as 24% chance of side effects. There have been deaths associated with its use. Single dose treatment has a resolution rate of 71%, 1 or 2 does a resolution rate of 84%. Would find it hard to get informed consent to treatment with as high a failure rate as this if there is a treatment with (as you say) a low moribidity and 100% success rate! Ref: Parker J, Bisits A, Proietto AM. A systematic review of single-dose intramuscular methotrexate for the treatment of ectopic pregnancy. Aust NZ J Obstet Gynaecol 1998; 38: 145 - 150. Peter Wein
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