Medical treatment of ectopic pregnancy and clinical score

INTRODUCTION: Ectopic pregnancy is an important cause of morbidity and mortality worldwide. Furthermore, with earlier diagnosis, medical therapy with methotrexate can be offered and surgery avoided in some women, though the best regimen remains unclear. Although there have been advances in the management of ectopic pregnancy, there are still questions to be answered. OBJECTIVE: The use of clinical score was evaluated after the clinical treatment for selection of patients for medical treatment of ectopic pregnancy. METHOD: One hundred and twenty five patients were treated by methotrexate. The administration route was local, ultrasonographically controlled or intramuscular. The first dose of methotrexate was 50 mg and maximal total dosage was 200 mg. RESULTS: Methotrexate treatment of ectopic pregnancy was effective in 85% of cases. In the group of patients with clinical score under 10, the medical treatment was successful in 95% of cases. In the group of patients with clinical score over 14, the medical outcome was successful in 33% of cases. The administration route did not influence the treatment outcome. CONCLUSION: Methotrexate treatment of ectopic pregnancy is a very effective manner of treatment. Clinical (numeric) score is very useful for selection of patients with ectopic pregnancy and may have prognostic value for medical treatment outcome.