Methotrexate treatment for tubal pregnancy: Criteria for medical approach

G. Cobellis, G. Pierno, E. Pecori, C. Scaffa, L. Stradella, E. M. Messalli, B. Festa, L. Cobellis

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim. The purpose of this retrospective study is to underline the indications for the use of systemic methotrexate (MTX) in tubal pregnancies. Methods. One hundred- and four (n=104) consecutive women were treated in our Department for tubal pregnancy. The database analysis showed that after careful respect for inclusion criteria, the treatment chosen was the intravenous administration of MTX in 68 patients, whereas laparoscopy constituted the primary treatment in 36 patients. A single dose of MTX was intravenously administered, diluted in saline solution, with a dosage of 50 mg/m2 of body surface. Close serum β-hCG monitoring was performed, and in the case of a short fall, a 2nd dose of methotrexate was submitted. Results. The overall success rate of MTX treatment was 91%; the 2nd dose of MTX was used in 12% of patients, whereas in only 6 out of 68 patients included in the medical treatment group a surgical approach for suspected tubal rupture was necessary. Conclusion. Treatment with methotrexate is effective and safe in the presence of these criteria: patient hemodynamically stable, absence of tubal rupture sign and hemoperitoneum, an adnexal mass with a diameter ≤5 cm, an amenorrhea ≤6 weeks and HCG levels ≤10 000 mIU/ml. Laparoscopy is indicated in diagnostic uncertainty, when MTX is not suggested, when adnexal mass is >5 cm, or in patients in which β-hCG levels was >10 000 mIU/ml.

Original languageEnglish
Pages (from-to)531-535
Number of pages5
JournalMinerva Ginecologica
Volume55
Issue number6
Publication statusPublished - Dec 2003

Fingerprint

Tubal Pregnancy
Methotrexate
Therapeutics
Laparoscopy
Rupture
Hemoperitoneum
Amenorrhea
Sodium Chloride
Intravenous Administration
Uncertainty
Retrospective Studies
Databases

Keywords

  • Laparoscopy
  • Methotrexate
  • Pregnancy, ectopic
  • Pregnancy, tubal

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Cobellis, G., Pierno, G., Pecori, E., Scaffa, C., Stradella, L., Messalli, E. M., ... Cobellis, L. (2003). Methotrexate treatment for tubal pregnancy: Criteria for medical approach. Minerva Ginecologica, 55(6), 531-535.

Methotrexate treatment for tubal pregnancy : Criteria for medical approach. / Cobellis, G.; Pierno, G.; Pecori, E.; Scaffa, C.; Stradella, L.; Messalli, E. M.; Festa, B.; Cobellis, L.

In: Minerva Ginecologica, Vol. 55, No. 6, 12.2003, p. 531-535.

Research output: Contribution to journalArticle

Cobellis, G, Pierno, G, Pecori, E, Scaffa, C, Stradella, L, Messalli, EM, Festa, B & Cobellis, L 2003, 'Methotrexate treatment for tubal pregnancy: Criteria for medical approach', Minerva Ginecologica, vol. 55, no. 6, pp. 531-535.
Cobellis G, Pierno G, Pecori E, Scaffa C, Stradella L, Messalli EM et al. Methotrexate treatment for tubal pregnancy: Criteria for medical approach. Minerva Ginecologica. 2003 Dec;55(6):531-535.
Cobellis, G. ; Pierno, G. ; Pecori, E. ; Scaffa, C. ; Stradella, L. ; Messalli, E. M. ; Festa, B. ; Cobellis, L. / Methotrexate treatment for tubal pregnancy : Criteria for medical approach. In: Minerva Ginecologica. 2003 ; Vol. 55, No. 6. pp. 531-535.
@article{299f782dd0d549c68dcff0535e0d7070,
title = "Methotrexate treatment for tubal pregnancy: Criteria for medical approach",
abstract = "Aim. The purpose of this retrospective study is to underline the indications for the use of systemic methotrexate (MTX) in tubal pregnancies. Methods. One hundred- and four (n=104) consecutive women were treated in our Department for tubal pregnancy. The database analysis showed that after careful respect for inclusion criteria, the treatment chosen was the intravenous administration of MTX in 68 patients, whereas laparoscopy constituted the primary treatment in 36 patients. A single dose of MTX was intravenously administered, diluted in saline solution, with a dosage of 50 mg/m2 of body surface. Close serum β-hCG monitoring was performed, and in the case of a short fall, a 2nd dose of methotrexate was submitted. Results. The overall success rate of MTX treatment was 91{\%}; the 2nd dose of MTX was used in 12{\%} of patients, whereas in only 6 out of 68 patients included in the medical treatment group a surgical approach for suspected tubal rupture was necessary. Conclusion. Treatment with methotrexate is effective and safe in the presence of these criteria: patient hemodynamically stable, absence of tubal rupture sign and hemoperitoneum, an adnexal mass with a diameter ≤5 cm, an amenorrhea ≤6 weeks and HCG levels ≤10 000 mIU/ml. Laparoscopy is indicated in diagnostic uncertainty, when MTX is not suggested, when adnexal mass is >5 cm, or in patients in which β-hCG levels was >10 000 mIU/ml.",
keywords = "Laparoscopy, Methotrexate, Pregnancy, ectopic, Pregnancy, tubal",
author = "G. Cobellis and G. Pierno and E. Pecori and C. Scaffa and L. Stradella and Messalli, {E. M.} and B. Festa and L. Cobellis",
year = "2003",
month = "12",
language = "English",
volume = "55",
pages = "531--535",
journal = "Minerva Ginecologica",
issn = "0026-4784",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "6",

}

TY - JOUR

T1 - Methotrexate treatment for tubal pregnancy

T2 - Criteria for medical approach

AU - Cobellis, G.

AU - Pierno, G.

AU - Pecori, E.

AU - Scaffa, C.

AU - Stradella, L.

AU - Messalli, E. M.

AU - Festa, B.

AU - Cobellis, L.

PY - 2003/12

Y1 - 2003/12

N2 - Aim. The purpose of this retrospective study is to underline the indications for the use of systemic methotrexate (MTX) in tubal pregnancies. Methods. One hundred- and four (n=104) consecutive women were treated in our Department for tubal pregnancy. The database analysis showed that after careful respect for inclusion criteria, the treatment chosen was the intravenous administration of MTX in 68 patients, whereas laparoscopy constituted the primary treatment in 36 patients. A single dose of MTX was intravenously administered, diluted in saline solution, with a dosage of 50 mg/m2 of body surface. Close serum β-hCG monitoring was performed, and in the case of a short fall, a 2nd dose of methotrexate was submitted. Results. The overall success rate of MTX treatment was 91%; the 2nd dose of MTX was used in 12% of patients, whereas in only 6 out of 68 patients included in the medical treatment group a surgical approach for suspected tubal rupture was necessary. Conclusion. Treatment with methotrexate is effective and safe in the presence of these criteria: patient hemodynamically stable, absence of tubal rupture sign and hemoperitoneum, an adnexal mass with a diameter ≤5 cm, an amenorrhea ≤6 weeks and HCG levels ≤10 000 mIU/ml. Laparoscopy is indicated in diagnostic uncertainty, when MTX is not suggested, when adnexal mass is >5 cm, or in patients in which β-hCG levels was >10 000 mIU/ml.

AB - Aim. The purpose of this retrospective study is to underline the indications for the use of systemic methotrexate (MTX) in tubal pregnancies. Methods. One hundred- and four (n=104) consecutive women were treated in our Department for tubal pregnancy. The database analysis showed that after careful respect for inclusion criteria, the treatment chosen was the intravenous administration of MTX in 68 patients, whereas laparoscopy constituted the primary treatment in 36 patients. A single dose of MTX was intravenously administered, diluted in saline solution, with a dosage of 50 mg/m2 of body surface. Close serum β-hCG monitoring was performed, and in the case of a short fall, a 2nd dose of methotrexate was submitted. Results. The overall success rate of MTX treatment was 91%; the 2nd dose of MTX was used in 12% of patients, whereas in only 6 out of 68 patients included in the medical treatment group a surgical approach for suspected tubal rupture was necessary. Conclusion. Treatment with methotrexate is effective and safe in the presence of these criteria: patient hemodynamically stable, absence of tubal rupture sign and hemoperitoneum, an adnexal mass with a diameter ≤5 cm, an amenorrhea ≤6 weeks and HCG levels ≤10 000 mIU/ml. Laparoscopy is indicated in diagnostic uncertainty, when MTX is not suggested, when adnexal mass is >5 cm, or in patients in which β-hCG levels was >10 000 mIU/ml.

KW - Laparoscopy

KW - Methotrexate

KW - Pregnancy, ectopic

KW - Pregnancy, tubal

UR - http://www.scopus.com/inward/record.url?scp=0842284129&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0842284129&partnerID=8YFLogxK

M3 - Article

C2 - 14676743

AN - SCOPUS:0842284129

VL - 55

SP - 531

EP - 535

JO - Minerva Ginecologica

JF - Minerva Ginecologica

SN - 0026-4784

IS - 6

ER -