Author:

Abstract:

The multiple-dose intramuscular administration of methotrexate is an alternative treatment option for the hemodynamically stable patient with an unruptured tubal pregnancy without signs of active intraperitoneal bleeding and presenting with low initial serum hCG (< 3000 IU/1). Of paramount importance is the early and definitive non-invasive diagnosis of ectopic pregnancy ruling out a viable intra-uterine (or heterotopic) pregnancy. All patients treated with methotrexate need a close follow-up until hCG is no longer detectable in the serum. Methotrexate should be used in the treatment of persistent ectopic pregnancy following salpingostomy as well as extratubal (early interstitial < 10 weeks and cervical) pregnancy.