Evaluación del tratamiento médico del embarazo ectópico con metotrexato

Objectives

To evaluate the efficacy of medical treatment with methotrexate in ectopic pregnancy.

Material and methods

We performed a prospective observational study of the use and effectiveness of medical treatment with methotrexate in patients diagnosed with ectopic pregnancy in the Ciudad Real University General Hospital from 2008 to 2009. A single intramuscular dose was administered in patients who met the inclusion criteria. Medical treatment was considered to have failed when surgery was required. We analyzed the economic costs of medical and surgical treatment.

Results

We diagnosed 63 cases of ectopic pregnancy. Forty patients (63.5%) were treated with methotrexate, and 23 women (36.5%) who did not meet the criteria for inclusion in the protocol for medical treatment were treated surgically (laparoscopic salpingectomy). Among patients who received methotrexate, 30 (82.5%) required only one dose and 10 (17.5%) required two doses. Methotrexate treatment was successful in 30 patients (75%) and failed in 10 (25%), who underwent a laparoscopic salpingectomy. The cost per case of medical treatment was 580 €, which was less than the cost of laparoscopic surgical treatment (3,465.8 €).

Conclusions

Methotrexate treatment of ectopic pregnancy in selected patients is as effective as the standard treatment with laparoscopy with less cost and with high acceptance by patients.