Success Rates of Single-Dose versus Multiple-Dose Methotrexate Protocols in the Treatment of Unruptured Tubal Ectopic Pregnancy: A Hospital Based Comparative Study

Abstract

Background: Methotrexate has become an established non-surgical treatment option for ectopic pregnancy, especially in cases where the pregnancy is unruptured and the patient is hemodynamically stable.
Objectives: To compare the success rates of single versus multiple dose methotrexate protocols for the treatment of unruptured tubal ectopic pregnancy.
Methods: This was a hospital based comparative study conducted in the Department of Obstetrics and Gynaecology, Vinayaka Missions Medical College & Hospital, Karaikal, Puducherry, India (tertiary care centre) between January and June 2024.
Results: In this study, 40 women with unruptured tubal ectopic pregnancy were divided into two groups: Group A received a single intramuscular dose of 50 mg/m² methotrexate, and Group B received multiple doses. Baseline characteristics such as age, gravida, parity, gestational age, hCG levels, and the size of the mass on sonograph were comparable between the two groups, with no statistically significant differences. Group A had an 80% success rate, while Group B had a 90% success rate. Analysis of potential confounding factors (sociodemographic, obstetric, laboratory, and sonographic variables) revealed no significant impact on the success rates between the two groups.
Conclusion: Both single and multiple doses of methotrexate were effective for treating unruptured tubal ectopic pregnancy, with no significant difference in outcomes or variables measured between the two groups.