Intratubal methotrexate for prevention of persistent ectopic pregnancy after salpingotomy.

STUDY

OBJECTIVE

To investigate whether frequency of persistent ectopic pregnancy after linear salpingotomy can be reduced by prophylactic administration of a single intraoperative injection of local methotrexate.

DESIGN

Prospective, randomized, controlled trial (Canadian Task Force classification I).

SETTING

University-affiliated hospital.

PATIENTS: Sixty-five women with unruptured ectopic pregnancy.

INTERVENTION: Laparoscopic salpingotomy with or without a single intratubal dose of methotrexate 1 mg/kg.

MEASUREMENTS AND MAIN

RESULTS

In the prophylaxis group, 22 patients received a single dose of intratubal methotrexate 1 mg/kg after linear salpingotomy; 43 controls had only linear salpingotomy. Six women (14%) in the control group developed persistent ectopic pregnancy, compared with none in the prophylaxis group (p <0.05).

CONCLUSION

In our opinion, intratubal methotrexate injection during laparoscopic salpingotomy is a practical option for women with unruptured ectopic pregnancy.