The Medical management of Unruptured Ectopic Pregnancy with Methotrexate - one year follow up

The use of medical management of unruptured ectopic pregnancy is an accepted alternative to surgical therapy. The use of transvaginal ultrasound has increased the early diagnosis of unruptured ectopic pregnancy. Methotrexate is a folic acid antagonist, which is widely used, at 50 mgm. A retrospective analysis of the Medical management of unruptured ectopic pregnancy from August 2011 to July 2012, at a teaching hospital in Tamilnadu, showed that out of the total of 27 patients who were diagnosed to have unruptured ectopic pregnancy, only 41 had medical management. The success rate was only 55, whereas 90 success rate is achievable, by statistics. The probable reason for failure of medical management includes the use of inappropriate dosage of Methotrexate ( use of less than ideal dose), size of the mass more than 4 cms, the presence of cardiac activity and failure to repeat Methotrexate as per the regimen.