Tratamiento con metotrexato del embarazo ectópico no complicado. Experiencia de 10 años

Article information

Resumen

Objetivo

Averiguar la eficacia del tratamiento con metotrexato intramuscular en los casos de embarazos ectópicos no complicados

Sujetos Y Métodos

Desde noviembre de 1990 hasta diciembre de 2000 se trató a 112 pacientes con embarazo ectópico con 50 mg/m2 de metotrexato siguiendo la pauta de Stovall

Resultados

Un total de 95 pacientes (85%) respondio favorablemente a la terapia, y 22 de ellas necesitaron una dosis adicional. Requirieron tratamiento quirurgico 17 pacientes (15%), por dolor y/o hemoperitoneo. Aparecieron efectos secundarios leves en 48 pacientes (43%), el mas frecuente de los cuales fue el dolor pelvico, resuelto con analgesicos. Los factores predictivos del exito del tratamiento fueron tener una β-HCG menor de 1.500mU/ml y el descenso de la cifra de leucocitos al cuarto dia postratamiento

Conclusión

Nuestros datos confirman que la terapia con metotrexato intramuscular en dosis única supone una terapia con una alta eficacia a corto y largo plazo, en el tratamiento del embarazo ectópico no complicado, con un índice de complicaciones graves relativamente pequeño

Palabras clave:

Embarazo ectópico

Tratamiento médico

Metotrexato

Abstract

Objective

To determine the efficacy of intramuscular methotrexate in the treatment of unruptured ectopic pregnancy

Subjects And Methods

From November 1990 to December 2000, 112 patients with ectopic pregnancy were treated with 50 mg/m2 of methotrexate in single doses

Results

Ninety-five women (85%) responded well to the therapy while 22 required a second dose

Seventeen patients (15%) required surgical treatment for pain and/or hemoperitoneum. Forty-eight patients (43%) showed mild adverse effects, the most frequent being pelvic pain, which was resolved with analgesics. Predictive factors for a favorable response were β-human chorionic gonadotropin levels < 1500mU/mL before treatment and a decrease in leucocyte count on the fourth day after treatment

Conclusion

Our data confirm that single-dose intramuscular methotrexate therapy in unruptured ectopic pregnancy is highly effective both in the short- and the long term with relatively few severe complications

Keywords:

Ectopic pregnancy

Medical treatment

Methotrexate

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