Retrospective review of the medical management of ectopic pregnancies with methotrexate at a South African tertiary hospital

• DOI: 10.7196/sajog.920
• Publication Date: 2014-11-13T10:34:58Z
• Authors: Liesl De Waard; J L Butt; C J B Muller; C A Cluver
• Keywords: Tertiary care

Background. An ectopic pregnancy can be a life-threatening condition. Early diagnosis with ultrasonography and quantitative beta-human chorionic gonadotrophin (β-hCG) measurement has improved early accurate treatment. Medical management methotrexate internationally success rate of up to 93%, but there is paucity data on this treatment option in developing countries. Objective. To determine the for pregnancies at referral hospital country. This non-surgical, outpatient seems good hospitals an ever-rising pressure bed occupation long waiting lists emergency surgery. Methods. A 5-year retrospective audit was performed 124 patients treated Tygerberg Hospital, Cape Town, South Africa. Results. With defined as β-hCG level <15 IU/L without requiring surgical intervention, 44%. Fifteen per cent medically managed required The remaining 41% were lost follow-up. One patient had major adverse outcome ruptured 2 units blood, resuscitation laparotomy. Conclusion. safe effective option, proven by international data, Hospital safety modality cannot guaranteed because poor Improvement selection consideration predictors thorough counselling, well full informed consent, recommended before using modality. new follow-up system should developed guarantee safety.