doses methotrexate ectopic pregnancy

3 doses of methotrexate for ectopic pregnancy

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Article / Publication Details

First-Page Preview

Received: December 13, 2017
Accepted: June 18, 2018
Published online: August 10, 2018

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: //www.karger.com/GOI

Abstract

Objective: To investigate the clinical results and prognostic factors of multiple dose methotrexate (Mtx) treatment of ectopic pregnancy patients with high initial serum (human chorionic gonadotropin [hCG]). Design: Retrospective cohort study. Patients: Twenty-six ectopic pregnancy patients with serum (βhCG) > 5,000 mIU/mL who received multiple doses of Mtx (1 mg/kg) with folinic acid rescue on the alternating days. Results: Success rate was 88.5%. All failures were tubal ruptures in those who underwent surgery. Median initial hCG values of the success and the failure patients were 8,582 (5,058–31,114) and 5,280 (5,042–13,563) mIU/mL respectively (p > 0.05). Side effects were seen in 18 patients (69.2%, one bone marrow suppression and 17 minor side effects). The number of Mtx injections (7.04 ± 1.71), Mtx dose (71.35 ± 13.16 mg) and follow-up period (42.04 ± 23.77 days) did not differ between groups. Body mass index (BMI), Mtx dose, number of Mtx and change in βhCG levels between the initials and the levels measured 2 days after the 3rd, 4th, and 5th Mtx injections were found to be highly predictive for tubal rupture. Conclusions: Multiple-dose Mtx treatment of ectopic pregnancies with high initial hCG is safe and effective. BMI, Mtx dose, number of Mtx injections and the decrement of βhCG levels were found as highly predictive for the success of the treatment.

© 2018 S. Karger AG, Basel

References

  1. Barnhart KT, Gosman G, Ashby R, Sammel M: The medical management of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynecol 2003; 101: 778–784.
  2. Skubisz MM, Tong S: The evolution of Mtx as a treatment for ectopic pregnancy and gestational trophoblastic neoplasia: a review. Obstet Gynecol 2012; 2012: 637094.
  3. Bachman EA, Barnhart K: Medical management of ectopic pregnancy: a comparison regimens. Clin Obstet Gynecol 2012; 55: 440–447.
  4. Barnhart K, Hummel AC, Sammel MD, Menon S, Jain J, Chakhtoura N: Use of “2-dose” regimen of methotrexate to treat ectopic pregnancy. Fertil Steril 2007; 87: 250–256.
  5. Menon S, Colins J, Barnhart KT: Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril 2007; 87: 481–484.
  6. Lipscomb GH, McCord ML, Stovall TG, Huff G, Portera SG, Ling FW: Predictors of success of methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med 1999; 341: 1874–1878.
  7. Alleyassin A, Khademi A, Aghahosseini M, Safdarian L, Badenoosh B, Hamed EA: Comparison of success rates in the medical management of ectopic pregnancy with single-dose and multiple-dose administration of methotrexate: a prospective, randomized clinical trial. Fertil Steril 2006; 85: 1661–1666.
  8. Lipscomb GH, Givens VM, Meyer NL, Bran D: Comparison of multidose and single-dose Methotrexate protocols for the treatment of ectopic pregnancy. AJOG 2005; 192: 1844–1848.
  9. The Practice Committee of the American Society for Reproductive Medicine: Medical treatment of ectopic pregnancy. Fertil Steril 2008; 90: 206–212.
  10. Hamed HO, Ahmed SR, Alghasham AA: Comparison of double- and single-dose methotrexate protocols for treatment of ectopic pregnancy. Int J Gynecol Obstet 2012; 116: 67–71.
  11. Kim K, Suh DH, Cheong HH, Yoon SH, Lee TS, No JH, Kim YB: Efficacy of methotrexate therapy in patients with tubal pregnancy and a serum human chorionic gonadotropin level above 10,000 IU/L. Clin Exp Reprod Med 2014; 41: 33–36.
  12. Lipscomb GH: Medical therapy for ectopic pregnancy. Semin Reprod Med 2007; 25: 93–98.
  13. Uyar I, Yucel OU, Gezer C, Gulhan I, Karis B, Hanhan HM, Ozeren M: Effect of single-dose methotrexate on ovarian reserve in women with ectopic pregnancy. Fertil Steril 2013; 100: 1310–1313.
  14. Capmas P, Bouyer J, Fernandez H: Treatment of ectopic pregnancies in 2014: new answers to some old questions. Fertil Steril 2014; 101: 615–620.

Article / Publication Details

First-Page Preview

Received: December 13, 2017
Accepted: June 18, 2018
Published online: August 10, 2018

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: //www.karger.com/GOI

How many times can you take methotrexate for ectopic pregnancy?

You often only need 1 dose. Sometimes you will need a second dose. You will need to have blood tests to check the level of pregnancy hormone (hCG). You will get your blood drawn 3 separate times the first week.

How long does it take for an ectopic pregnancy to dissolve after having methotrexate?

When this happens, we know that the medication has worked. This can take at least 4-6 weeks.

How many ml of methotrexate should I take for ectopic pregnancy?

Methotrexate may be given in one dose at 50 mg/m2 for the treatment of an ectopic. Methotrexate may also be given using a “multidose” regimen of 1 mg/kg intramuscularly, alternating with 0.1 mg/kg of leucovorin intramuscularly for up to four daily doses of each drug [2] .

What happens after methotrexate injection for ectopic pregnancy?

The most common side effect of methotrexate is some cramping belly pain. This pain usually occurs in the first one to two days of treatment. You may also start or continue to see vaginal bleeding or spotting, or have other GI side effects, like nausea, vomiting, or indigestion.

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