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Obstetrics and Gynecology International
Volume 2015, Article ID 902426, 5 pages
Clinical Study

Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

1Obstetrics and Gynecology Department, King Fahad Medical City, Riyadh, Saudi Arabia
2King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
3Obstetrics and Gynecology Department, King Abdulaziz Medical City, King Saud Bin Abdualziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
4Obstetrics and Gynecology Department, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Science (KSAU-HS), P.O. Box 9515, Jeddah 21423, Saudi Arabia

Received 13 January 2015; Revised 11 February 2015; Accepted 23 February 2015

Academic Editor: Robert Coleman

Copyright © 2015 Feras Sendy et al. 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.


Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate. Results. 225 patients had methotrexate. Most of the patients (151 (67%)) received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225) of the patients. 28% (63/225) were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63) of failure received a second dose of methotrexate, and 37% (23/63) underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound. Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.