Table of Contents
ISRN Obstetrics and Gynecology
Volume 2012 (2012), Article ID 637094, 8 pages
Review Article

The Evolution of Methotrexate as a Treatment for Ectopic Pregnancy and Gestational Trophoblastic Neoplasia: A Review

1Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg, 3084 VIC, Australia
2Department of Obstetrics & Gynaecology, Monash University, Level 5, Monash Medical Centre, 246 Clayton Road, Clayton, 3168 VIC, Australia

Received 7 November 2011; Accepted 5 December 2011

Academic Editors: A. Jazaeri and F. M. Reis

Copyright © 2012 Monika M. Skubisz and Stephen Tong. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Methotrexate was developed in 1949 as a synthetic folic acid analogue to compete with folic acid and thus interfere with cell replication. While initially developed as a potential treatment for acute lymphoblastic leukaemia, a serendipitous observation led to methotrexate's use to effect the dramatic cure of a case of advanced choriocarcinoma. This prompted the exploration for the potential of methotrexate to treat other conditions involving disordered trophoblastic tissue. Methotrexate has subsequently revolutionized the treatment of two pregnancy-related conditions—gestational trophoblastic neoplasia and ectopic pregnancy. This article reviews the development of modern treatment protocols that use methotrexate to medically treat these two important gynaecological conditions.