METHOTREXATE TREATMENT OF TUBAL ECTOPIC PREGNANCY: EXPERIENCE OF HOSPITAL OF LITHUANIAN UNIVERSITY OF HEALTH SCIENCES KAUNO KLINIKOS

Abstract

Aim. To identify tubal ectopic pregnancies treatment with methotrexate outcomes in LUHS Obstetrics and Gynaecology department. Methods. A retrospective analysis was conducted for LUHS Kauno Klinikos Obstetrics and Gyneacology department register data. All 2018-2019 tubal ectopic pregnancy cases (n=40), where methotrexate was administrated, were analyzed. These criteria were evalueted: female demographics, risk factors and symptoms of tubal ectopic pregnancy, ultrasound findings, human chorionic gonadotropin (hCG) levels, number of methotrexate doses, treatment efficacy, and whether methotrexate was administered according to recently recommended criteria. Results. Most patients were pregnant for the first time and on average about 6 weeks of gestation, complained of abdominal pain and vaginal bleeding, which ultrasound usually showed a heterogeneous structure of varying size in the field of uterine adnexa. In most cases (92.5 %) methotrexate was administrated according to recommended criteria. The outcome of methotrexate treatment is unknown in 35 % cases of all woman. Treatment of tubal ectopic pregnancy with methotrexate was effective in 76.9 % of cases. Three out of four women (75 %) received a single dose, rest required the second dose of methotrexate. Urgent surgery was performed in 23.1 % of women, but when methotrexate was prescribed according to the recommended criteria - 17.4 %. All operations were performed after the first drug dose. Conclusion. At LUHS Kauno klinikos treatment of tubal ectopic pregnancy with methotrexate was successful in 76.9 % of women. Although the results are very similar to the scientific literature, further prospective studies are needed.