Analyzing the clinical significance of postoperative methotrexate in the management of early abdominal pregnancy: analysis of 10 cases

Objectives: To assess the clinical value and treatment outcomes of postoperative methotrexate (MTX) therapy in the management of early abdominal pregnancy.  Material and methods: We retrospectively analyzed ten (10) cases of early abdominal pregnancy at our hospital between 7th August, 2006 and 20th April, 2017.  Results: Out of the ten (10) cases identified, six (6) patients and four (4) patients underwent surgery (laparotomy or laparoscopy) only and surgery (laparotomy or laparoscopy) plus IM 50 mg/m2 methotrexate (MTX) within 24 hours of surgery respectively. The gestation age and serum β-HcG levels were significantly lower (p < 0.05, 6.0 ± 1.82 and 8073.2 ± 9561.0) in the surgery plus MTX group in comparison to (7.33 ± 3.61 and 15625 ± 21275.2) for the surgery only group. Ultrasound imaging findings reported extra uterine pregnancy in all cases and diagnostic surgery was necessary to locate precise site of implantation to plan further treatment. Days of hospitalization were shorter in the surgery + MTX group than in the surgery only group (3.00 ± 0.816 versus 5.66 ± 2.80).  Conclusions: Earliness in diagnosis coupled with the appropriate (methotrexate) MTX regime could help prevent unwanted complications that could arise from delayed or misdiagnosis.