The treatment of unruptured tubal pregnancy with intratubal methotrexate injection under laparoscopic control.

Nine patients with unruptured tubal pregnancies of 6-9 weeks' duration were treated with methotrexate intratubal injection under laparoscopic control. Urinary hCG levels decreased immediately after completion of the procedure, with a median time of 11 days (range 1-29) to resolution. Tubal patency on the side of the ectopic gestation was confirmed by hysterosalpingography 1-3 months after the procedure in all cases. This method requires a reduced methotrexate dosage compared with intramural or intravenous therapy. The indications are unruptured tubal pregnancy of 4 cm or less in diameter and urinary hCG levels of 8000 mIU/mL or lower.