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Conservative treatment of ectopic pregnancies: Comparison of velocity of decrease of beta-hcg between spontaneous and methotrexate induced resorptions

Dokić Milan D. (Institut za ginekologiju i akušerstvo, Klinički centar Srbije, Beograd)
Perišić Dušan V. (Institut za ginekologiju i akušerstvo, Klinički centar Srbije, Beograd)

The evolution of the process can take two different directions. If an intact pregnancy continues to grow, there is a tubal abortion or a rupture of the Fallopian tube. In the oppsote case, there is spontaneous resorption of the tubal pregnancy. In certain cases with the application of methotrexate, the ectopic pregnancy growth can be interrupted and spontaneous resorption can be induced. Nowadays, the international standards of treating patients with early ectopic gravidities and no peritoneal effusions, with ß-HCG values below 6000 Ul/I, gestational sac diameter below 3 cm, and without any visible heart action, imply methotrexate treatment. The objective of this study is to prove the efficiency of methotrexate use in patients who meet the above criteria. The first group did not manifest satisfying decrease of ß-HCG after two measurements, so methotrexate was used, while the second group showed satisfying decrease of ß-HCG, measured on the third day. Comparing the velocity of decrease of ß-HCG level among both groups of patients, it was proved that iatrogenically induced decrease, that is to say the achieved resorption, was equal to the spontaneous resorption, which justified the use of methotrexate in ectopic pregnancy treatment.

Keywords: ectopic pregnancy, methotrexate