Methotrexate Treatment of Ectopic Tubal Pregnancy

Aim: This paper presents the results of our research and compares them with other recent papers on this topic. Methods: This study included 82 patients with ectopic tubal pregnancy who were hospitalized and treated in the Clinic for Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center from November 2022 to November 2023. The patients’ data were compared according to the treatment method, the initial level of serum human chorionic gonadotropin (hCG), and basic demographic and maternal parameters. Results: Laparoscopic salpingectomy was used to treat 58 (70.73%) patients, 15 (18.29%) patients were treated with methotrexate, and in three (3.65%) patients who received methotrexate the treatment was unsuccessful and surgery was required. The serum hCG level in all patients treated with methotrexate was below 2000 IU/L. Of the 82 included patients, mostly aged 30-39, 42 were nulliparous and 71 were able to conceive spontaneously. Conclusion: Our success rate of treatment with methotrexate roughly follows world trends. The serum hCG level is an essential but not an exclusive criterion for the decision on treatment. Further research is needed on how to treat patients with a serum hCG level between 2000 and 5000 IU/L with no significant clinical symptoms and unremarkable ultrasound findings.