Overview and guidelines of off-label use of methotrexate in ectopic pregnancy: report by CNGOF.

  title={Overview and guidelines of off-label use of methotrexate in ectopic pregnancy: report by CNGOF.},
  author={Henri Marret and Arnaud Fauconnier and Gil Dubernard and H{\'e}l{\`e}ne Misme and Laurence Lagarce and Magali Lesavre and H Fernandez and Camille Mimoun and Claire Tourette and Sandra Curinier and Benoit Rabishong and Aubert Agostini},
  journal={European journal of obstetrics, gynecology, and reproductive biology},

Safety considerations regarding Methotrexate off-label use in tubal ectopic pregnancy

The potentially severe side effects of MTX therapy, although their occurrence is low, highlights the need for an adequate counseling before treatment initiation and Practitioners should provide patients with detailed information regarding follow-up modalities, failure rate, potential adverse events and de novo symptoms requiring immediate medical evaluation.

Use of methotrexate in the treatment of ectopic pregnancies: a retrospective single center study

The results are consistent with previous studies and emphasize the fact that MTX is less effective above a certain level of hCG, and should not be used when hCG is higher than 5,000 IU/L and laparoscopic surgery should be performed.

Predictors and clinical features of methotrexate (MTX) therapy for ectopic pregnancy

The change in the β-hCG level between the initial day and the 4th day is an effective and early predictive tool for the success of methotrexate (MTX) treatment of ectopic pregnancy.

Clinical Presentation as a Predictor of the Response to Methotrexate Therapy in Patients with Ectopic Pregnancy

MTX treatment can be used to manage symptomatic patients with ectopic pregnancy and the success rate in symptomatic Patients is not different from that in asymptomatic patients, while Pretreatment and on day 4 posttreatment is associated with higher failure rate.

Early Ectopic Pregnancy Refractory to Methotrexate Treatment: A Case Report

Methotrexate (MTX) is known as a systemic treatment for early ectopic pregnancy with low serum beta-human chorionic gonadotropin (βhCG) levels. Here we present our experience of an unsatisfactory

Multidosing Intramuscular Administration of Methotrexate in Interstitial Pregnancy With Very High Levels of β-hCG: A Case Report and Review of the Literature

A case of a 36-year-old woman admitted to the Hospital of Salerno-Italy with a value of serum β-hCG of 35,993 IU/L, in stable haemodynamic condition, and a pharmacological approach was preferred to a surgical one, which can contribute to improve the decision making in the treatment of the interstitial pregnancy.

Early predictive factors of single dose methotrexate outcome in patients with ectopic pregnancy

Available literature does not support the use of early βhCG kinetics to plan post-treatment follow-up, except for patients displaying extreme changes, and larger and prospective studies are thus required to fully determine the clinical usefulness of such parameters.

A 10-Year Review of Methotrexate Treatment for Ectopic Pregnancy in a Malaysian Tertiary Referral Hospital

Early diagnosis of ectopic pregnancy may reduce morbidity and mortality and methotrexate treatment has been proven to be cost-effective and avoided risks associated with surgery and anaesthesia.

Effectiveness of conservative medical treatment for non-tubal ectopic pregnancies: a multicenter study.

Chemotherapy in the Emergency Department? There Is a Role for That: Methotrexate for Ectopic Pregnancy

Approximately 1.6% of all emergency department (ED) visits in the United States are for vaginal bleeding in early pregnancy, translating to around 500,000 ED visits per year. A potentially



Single-Dose Methotrexate for Treatment of Ectopic Pregnancy

Single-dose intramuscular methotrexate appears to be an effective medical treatment for the unruptured ectopic pregnancy of 3.5 cm or less in greatest dimension with or without cardiac activity.

Predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate

Is routine monitoring of hepatic and renal function beneficial following single-dose methotrexate treatment for ectopic pregnancy? A 4-year review of experience from a teaching hospital

  • A. DarbhamullaK. BhalS. Lal
  • Medicine
    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • 2008
The purpose of this review was to establish the safety profile of single dose methotrexate, which helps in the development of appropriate follow-up protocols for these patients in the future.

Current evidence on surgery, systemic methotrexate and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis.

This meta-analysis shows that laparoscopic surgery is the most cost-effective treatment for tubal EP and systemic MTX is a good alternative in selected patients with low serum hCG concentrations.

Medical treatment of ectopic pregnancies: a randomized clinical trial comparing methotrexate-mifepristone and methotrexate-placebo.

This study failed to demonstrate any benefit of the addition of mifepristone to methotrexate, and the quantitative interaction between treatment effect and baseline serum progesterone suggested that this combination could be limited to ectopic pregnancies associated with high serum progestersone concentrations.

Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomized comparison.

The results of this RCT show that expectant management is an alternative to treatment with systemic MTX in a single-dose regimen in women with an ectopic pregnancy or a PUL and low and plateauing serum hCG concentrations and that MTX, a potentially harmful drug, can be withheld in these women.