Study objective: To investigate whether frequency of persistent ectopic pregnancy after linear salpingotomy can be reduced by prophylactic administration of a single intraoperative injection of local methotrexate.
Design: Prospective, randomized, controlled trial (Canadian Task Force classification I).
Setting: University-affiliated hospital.
Patients: Sixty-five women with unruptured ectopic pregnancy.
Intervention: Laparoscopic salpingotomy with or without a single intratubal dose of methotrexate 1 mg/kg.
Measurements and main results: In the prophylaxis group, 22 patients received a single dose of intratubal methotrexate 1 mg/kg after linear salpingotomy; 43 controls had only linear salpingotomy. Six women (14%) in the control group developed persistent ectopic pregnancy, compared with none in the prophylaxis group (p <0.05).
Conclusion: In our opinion, intratubal methotrexate injection during laparoscopic salpingotomy is a practical option for women with unruptured ectopic pregnancy.