[Three-dimensional ultrasound evaluation of the efficacy and safety of single-dose systemic or local methotrexate injection for tubal pregnancy].

OBJECTIVE

To compare the efficacy and safety of single-dose systemic and local injection of methotrexate (MTX) in the treatment of tubal pregnancy (TP).

METHODS

The systemic group included 127 women with TP who received a single-dose MTX of 50 mg/m(2) given by intramuscular injection, and the local group included 118 women receiving single-dose MTX of 100 mg via local injection guided by three-dimensional (3D) ultrasound. The volume of ectopic masses and blood beta-human chorionic gonadotropin (beta-HCG) were measured before and after MTX administration. The TP was detected by 3D images reconstructed 3 months after MTX administration.

RESULTS

The success rate of treatment was 100% in the local group, significantly higher than that of 91.34% in the systemic group. After the first week of MTX injection, the speed of the ectopic mass resolution was 0.85+/-0.04 cm(3)/d and 0.47+/-0.03 cm(3)/d in systemic group and local group respectively (P<0.05), and the time of the ectopic mass resolution was 27.66+/-12.77 d and 32.62+/-12.75 d, respectively (P<0.01). The rate of tubal deformity in the local group was significantly lower than that in the systemic group.

CONCLUSION

Local injection of MTX under ultrasound guidance is safe, efficient and reliable for conservative management of unruptured TP, which is superior to systemic injection.