Single-dose methotrexate Combined with Chinese medicinal herbs treated unruptured and ruptured ectopic pregnancy

Abstract

Objective: To explore the therapeutic effect of single-dose methotrexate (MTX) with Chinese medicinal herbs in the treatment of ectopic pregnancy(EP).Methods: Eighty-five patients with unruptured and ruptured EP were prospectively treated with an intramuscular injection of MTX (50 mg/m²) without citrovorum factor rescue to destroy embryo and villi, meanwhile, EP 1 decoction was given orally, in the case of ruptured EP with active internal hemorrhage resulted from EP mass rupture, or EP 2 decoction was given orally, in the case of unruptured EP and ruptured EP without active internal hemorrhage resulted from EP mass rhexis and blood in the peritoneal cavity has already formed hematomas. The serum human chorionic gonadotropin (hCG) (3-subunit were monitored regularly until they were undetectable. Serial B-ultrasound examinations were followed up by observing the gestational sac, fetal cardiac activity, EP mass absorption, etc. Of those who has the desire of being pregnant, after all EP mass disappeared, hysterosalpingogram may be performed.Results: The total of 81 cases (95.3%) were successfully treated without surgical operation, 4 cases (4.7%) required surgical management of EP. The mean serum hCG β-subunit clearance time was 18.7 β 7.2 days. Total disappearance of EP mass assessed by transvaginal ultrasonography, was 1.2 β 0.7 months. Hysterosalpingograms done on 20 patients of attempting pregnancy subsequently demonstrated tubal patency in 90.0% (18 cases) on the affected side. To date, 15 intrauterine pregnancies have occurred in this group, none of the patients were recurrent EP.Conclusions: EP were treated with integrated traditional Chinese and western medicine, it may expand the EP indication treated with MTX alone, elevate cure rate and obtain ideal efficacy without surgical intervention.