Nonsurgical management of unruptured isthmic ectopic pregnancy: preliminary experience

Int J Fertil. 1988 Mar-Apr;33(2):116-9.


Five unruptured isthmic tubal pregnancies diagnosed at laparoscopy were treated with either methotrexate/citrovorum factor rescue (MTX/CF) (n = 4) or observation alone (n = 1). Entry criteria required that the ectopic be fully visualized, no greater than 3 cm in diameter, with intact serosa, and without active bleeding. Treatment selection was based upon preoperative levels of beta-hCG with MTX/CF given to subjects exhibiting a plateaued or rising pattern and observation alone given those with falling levels. Subjects were followed with serial measurements of beta-hCG, complete blood counts, and liver function tests. In all subjects the ectopic pregnancy resolved without further surgery. Time to resolution (first day of treatment to undetectable beta-hCG) ranged from 12 to 55 days. Of the five subjects studied, follow-up hysterosalpingograms in four demonstrated tubal patency on the side of the ectopic gestation.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Animals
  • Chorionic Gonadotropin / analysis
  • Clinical Protocols / standards
  • Drug Therapy, Combination
  • Fallopian Tubes / surgery
  • Female
  • Humans
  • Leucovorin / pharmacology
  • Leucovorin / therapeutic use
  • Methotrexate / pharmacology
  • Methotrexate / therapeutic use
  • Oviducts / drug effects
  • Pregnancy
  • Pregnancy, Ectopic / drug therapy*
  • Pregnancy, Ectopic / surgery


  • Chorionic Gonadotropin
  • Leucovorin
  • Methotrexate