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Archives of Gynecology and Obstetrics

, Volume 265, Issue 2, pp 82–84 | Cite as

Methotrexate versus hyperosomolar glucose in the treatment of extrauterine pregnancy

  • O. Sadan
  • S. Ginath
  • A. Debby
  • S. Rotmensch
  • A. Golan
  • H. Zakut
  • M. Glezerman
Original Article

Abstract 

The aim of this prospective, randomized, double blind study was to compare the efficacy of methotrexate and hyperosmolar glucose injected directly into the extra-uterine gestational sac under laparoscopic vision. The study included twenty women with ectopic pregnancy. Inclusion criteria were intact tubal pregnancy, not exceeding 4 cm in diameter, rising or plateauing βhCG levels, and no evidence of intra-abdominal bleeding. The patients were treated by laparoscopically guided injection of 3 mL fluid into the area containing the tubal pregnancy. The fluid contained either 25 mg methotrexate (n=9) or 50% glucose (n=9). Daily decrease in βhCG levels was faster in patients treated by methotrexate (median 8.7%) than in those treated by hyperosmolar glucose (median 4.8%), p=0.17. The study was discontinued due to a higher failure rate in the group treated by hyperosmolar glucose. In conclusion, local injection of methotrexate is superior to hyperosmolar glucose. It can be used as an alternative to salpingostomy or salpingotomy whenever laparoscopy is performed for the diagnosis and treatment of extra-uterine pregnancy.

Keywords Methotrexate Hyperosmolar glucose Ectopic pregnancy 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • O. Sadan
    • 1
  • S. Ginath
    • 1
  • A. Debby
    • 1
  • S. Rotmensch
    • 1
  • A. Golan
    • 1
  • H. Zakut
    • 1
  • M. Glezerman
    • 1
  1. 1.Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, 69978 Tel Aviv, IsraelIL

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