Two doses of methotrexate vs a single dose of methotrexate in Ectopic Tubal Pregnancy

A recent study compared the success rates and safety of two doses of methotrexate versus a single dose of methotrexate in ectopic tubal pregnancy.

It included 100 women (50 in each group) aged 20 to 35 years with an ectopic tubal pregnancy and randomized them to either single-dose or two-dose methotrexate protocol. It evaluated the Cases for treatment success, side effects, beta-human chorionic gonadotrophin (β-hCG) resolution time, and treatment satisfaction.

The study observed-

• Mean age of the patients as 29.6±4.5 years. 
• Mean serum β -hCG levels at baseline as 1212±78 mIU/ml. 
• Treatment success among 86.0% of cases of the single-dose group versus 90.0% of cases of the two-dose group. 
• Significantly shorter Duration of β -hCG resolution time in the two-dose group (23.0±12.1 days versus 28.2±12.8 days). 
• No significant difference in methotrexate-associated side effects in both study groups. 
• Mean satisfaction score as 4.0±1.3 (out of 5).

The study found that although β -hCG resolution time was significantly low in the two-dose protocol, single-dose methotrexate delivered comparable success rates versus the two-dose protocol. Side effects were mild and comparable in both methotrexate treatment protocols. Thus methotrexate treatment is effective in the medical management of ectopic pregnancy.

Pak J Med Sci. 2022 Jul-Aug;38(6):1436-1440. doi: 10.12669/pjms.38.6.5251. PMID: 35991243; PMCID: PMC9378401.