The medical treatment of unruptured ectopic pregnancy with methotrexate and citrovorum rescue: preliminary experience

Medical treatment of ectopic pregnancy

“…Medical treatment protocols for MTX were established in the late 1980s and have become a widely accepted primary treatment for ectopic pregnancy (27)(28)(29)(30)(31). MTX is a folic acid antagonist (26,32).…”

“…Schema for treatment and follow-up for the two regimens are summarized in Tables 2 and 3, respectively. The multiple-dose protocol is a regimen adapted from early experience with MTX treatment for trophoblastic disease and was the regimen first used to treat ectopic pregnancy (27,28). The multiple-dose protocol alternates MTX treatment with leucovorin therapy.…”

Use of “2-dose” regimen of methotrexate to treat ectopic pregnancy

“…Leucovorin (folinic acid) reverses the effects of methotrexate and is used to reduce side effects of large doses of methotrexate. This protocol allows for up to 4 doses of each to be administered before the treatment is deemed a failure (16,17).…”

Medical management of interstitial pregnancy with high serum beta-selective human chorionic gonadotrophin

“…33,34 The initial size of the ectopic was limited to ,3 cm in early reports. 35,36 This value has steadily increased to the point where size is no longer a major determinant for inclusion. The same is true for the presence of fetal cardiac activity, which is no longer an absolute contraindication to medical treatment.…”