Single‐dose systemic methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo‐controlled randomized trial

• Published in: Ultrasound in obstetrics & gynecology 2017-02, Vol.49 (2), p.171-176
• Main Authors: Jurkovic, D., Memtsa, M., Sawyer, E., Donaldson, A. N. A., Jamil, A., Schramm, K., Sana, Y., Otify, M., Farahani, L., Nunes, N., Ambler, G., Ross, J. A.
• Format: Article
• Language: English
• Subjects: Adult; Chorionic Gonadotropin, beta Subunit, Human - blood; expectant; Female; Humans; Intention to Treat Analysis; Logistic Models; methotrexate; Methotrexate - administration & dosage; Methotrexate - therapeutic use; placebo; Pregnancy; Pregnancy, Tubal - drug therapy; Pregnancy, Tubal - metabolism; Pregnancy, Tubal - surgery; randomized controlled trial; treatment; Treatment Outcome; tubal ectopic pregnancy; Young Adult
• ISSN: 0960-7692; 1469-0705
• DOI: 10.1002/uog.17329

ABSTRACT Objective Methotrexate is used routinely worldwide for the medical treatment of clinically stable women with a tubal ectopic pregnancy. This is despite the lack of robust evidence to show its superior effectiveness over expectant management. The aim of our multicenter randomized controlled trial was to compare success rates of methotrexate against placebo for the conservative treatment of tubal ectopic pregnancy. Methods This study took place in two early‐pregnancy units in the UK between August 2005 and June 2014. Inclusion criteria were clinically stable women with a conclusive ultrasound diagnosis of a tubal ectopic pregnancy, presenting with a low serum beta human chorionic gonadotropin (β‐hCG) level of