Intratubal methotrexate for prevention of persistent ectopic pregnancy after salpingotomy

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 1). 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 I 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.