Apoptosis versus necrosis in tubal ectopic pregnancies following Methotrexate

Int J Exp Pathol. 2023 Apr;104(2):76-80. doi: 10.1111/iep.12465. Epub 2023 Jan 24.

Abstract

Methotrexate administration for the treatment of tubal ectopic pregnancies has been shown to cause tubal mass enlargement. Our hypothesis was that, by administrating Methotrexate, a local necrotic reaction occurs, leading to hematoma formation and eventually fallopian tube rupture. Salpingectomy specimens were collected, analysed and divided into three equal groups: patients who received Methotrexate but who ultimately failed medical treatment, patients who had a viable ectopic pregnancy and patients with a self-resolving ectopic pregnancy that were operated due to other medical indications. The specimens were dyed using the Cleaved Caspase-3 (Asp175) Rabbit mA. Specimens were divided into three equal groups and analysed. The patients in self-resolving ectopic pregnancy group were older and had more pregnancies. Rates of apoptosis were found to be less than 1% per slide. Necrosis was not evident in any of the pathological specimens. It seems Methotrexate administration does not lead to a significant tubal necrotic reaction. Further studies are required.

Keywords: Methotrexate; apoptosis; ectopic; necrosis; pregnancy.

MeSH terms

  • Abortifacient Agents, Nonsteroidal* / adverse effects
  • Animals
  • Apoptosis
  • Female
  • Humans
  • Methotrexate / adverse effects
  • Necrosis / chemically induced
  • Pregnancy
  • Pregnancy, Ectopic* / chemically induced
  • Pregnancy, Ectopic* / surgery
  • Rabbits

Substances

  • Methotrexate
  • Abortifacient Agents, Nonsteroidal