[Can medical treatment be the first-line treatment for most ectopic pregnancies? A series of 202 patients].

OBJECTIVES

To assess the efficacy and safety of a liberal policy of medical treatment for ectopic pregnancies (EUP).

MATERIAL AND

METHODS

Retrospective study of EUP that received active management between January 1999 and December 2003. Patients with rupture or near-rupture and those who refused medical treatment received surgical treatment. Other patients were treated by methotrexate.

RESULTS

Two hundred and two EUP were managed; 26 % were treated surgically, 74 % medically. The success rate of medical treatment was 83 %. A ss-hCG threshold of 2526 IU/l was selected. Under this level, the success rate was 90.7 % compared with 68 % when it was higher (p=0.001). Cardiac activity tripled the failure rate. Morbidity with medical treatment consisted of an augmentation in transaminases in 18.8 % and one case of severe dermatosis (0.7 %). Almost half of the patients treated medically required hospitalizations.

CONCLUSION

The extension of medical treatment in our population to 74 % of all EUP yielded a high success rate, 83 %.