Double versus Single Dose Methotrexate Regimens in Management of Undisturbed Ectopic Pregnancy

Objective: To assess the effectiveness and safety of doubledose methotrexate in comparing to single-dose methotrexate for management of ectopic pregnancy.
Methods: A prospective randomized-controlled trial was conducted on 200 patients with ectopic pregnancy at the Obstetrics and gynecological Departments of Zagazig University, Egypt between June, 2011 to May 2014. Patients were randomized into two groups, ( group 1 ) who received a single dose 50 mg per meters squared surface area methotraxate (50 mg/m2 IM on day 1) intramuscularly or (group 2), who received double-dose methotrexate regimen (50 mg/m2 intramuscularly on days 0 and 4). The outcomes were; success rate, time duration of fall down of b-hcg to <15 mlU/mL and undesirable effects of methotrexate.
Results: In general, there is significant differences between both groups as regard the success rate and the duration of fall down β-hCG. The success rate was better in group 2 than in group 1 (90% versus 78.75%, P=0.01). The duration of fall down β-hCG until <15 mlU/mL was shorter in group 2 (P=0.01). There was no significant difference between groups in adverse effects.
Conclusion: Double-dose methotrexate as one of regimens of medical management of undisturbed ectopic pregnancy had more effectiveness and success rate than that of singledose regimen with equivalent safety.


Hend S Saleh, Hala E Mowafy, Azza A abd El Hameid, Walid A Abdelsalam and Hala E Sherif

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