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Re: ectopic pregnancies and IM methotrexateFrom: Thomas Ind (100333.1216@compuserve.com)Mon Dec 28 04:12:47 1998
Peter Am aware of the reference you refer to. It's like everything that is new. There is great enthusiasm and everyone uses it. Then there is a fright and noone uses it. Eventually it finds a balanced place in clinical practice. The reference you refer to highlight my worries. However I use it for assymptomatic ectopics who have a sac of <4cm, no fetal heart and an hCG of <10,000. All these rules apply at follow-up. From what I have read in the literature, using these rules is safe but if you have any further data I would be very interested. I give up after 2 dose (no evidence to say why but none to the contrary either). To date I have only treated 47 patients and subsequently have laparoscoped 3 of them (2 salpingectomies and one salpingostomy). I counsel them to the side effect and tell them the risks of failure.
-- Dr Thomas Ind MB BS MD MRCOG St George Hospital Kogarah Sydney NSW 2217 AUSTRALIA
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