Methotrexate local injection for unruptured tubal pregnancy: an alternative to laparotomy?

M. Pansky*, I. Bukovsky, A. Golan, A. Herman, I. Hertziano, R. Langer, E. Caspi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Fifty-nine women with early unruptured tubal pregnancy were treated by a single local injection of methotrexate at laparoscopy. All 59 patients underwent the procedure without any adverse reaction, 47 (80%) of them needing no laparotomy. Twelve patients required a laparotomy for reasons such as rising β-hCG levels and abdominal pain with or without rising levels of β-hCG. Only one patient ruptured the tube. None of the women needed a blood transfusion. We found tubal patency in 19 out of 21 patients at follow up hysterosalp-ingography. Eleven pregnancies were subsequently reported, one of them tubal. The appearance of the injected tube was absolutely normal in three patients, one at cesarean section and two at repeated laparoscopy. No peritubal adhesions were observed. We suggest that this new technique is a safe and effective alternative to laparotomy in a patient with an early unruptured tubal pregnancy.

Original languageEnglish
Pages (from-to)265-270
Number of pages6
JournalInternational Journal of Gynecology and Obstetrics
Issue number4
StatePublished - Mar 1992
Externally publishedYes


  • Methotrexate
  • Tubal Pregnancy


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