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Acta clinica Croatica, Vol. 64. No. 4, 2025.

Original scientific paper

https://doi.org/10.20471/acc.2025.64.04.14

Methotrexate Treatment of Ectopic Tubal Pregnancy

Neven Tučkar ; Sestre milosrdnice University Hospital Center, Department of Gynecology and Obstetrics, Zagreb; Catholic University of Croatia, Zagreb
Ana Benčić orcid id orcid.org/0000-0001-9612-4216 ; Sestre milosrdnice University Hospital Center, Department of Gynecology and Obstetrics, Zagreb *
Hrvojka Soljačić Vraneš ; Sestre milosrdnice University Hospital Center, Department of Gynecology and Obstetrics, Zagreb; Catholic University of Croatia, Zagreb
Antonija Kuna ; Catholic University of Croatia, Zagreb
Ena Radić ; Sestre milosrdnice University Hospital Center, Department of Gynecology and Obstetrics, Zagreb

* Corresponding author.

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Abstract

Aim: This paper presents the results of our research and compares them with other
recent papers on this topic.
Methods: This study included 82 patients with ectopic tubal pregnancy who were hospitalized and
treated in the Clinic for Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center
from November 2022 to November 2023. The patients’ data were compared according to the treatment
method, the initial level of serum human chorionic gonadotropin (hCG), and basic demographic and
maternal parameters.
Results: Laparoscopic salpingectomy was used to treat 58 (70.73%) patients, 15 (18.29%) patients
were treated with methotrexate, and in three (3.65%) patients who received methotrexate the treatment
was unsuccessful and surgery was required. The serum hCG level in all patients treated with methotrexate
was below 2000 IU/L. Of the 82 included patients, mostly aged 30-39, 42 were nulliparous and 71
were able to conceive spontaneously.
Conclusion: Our success rate of treatment with methotrexate roughly follows world trends. The
serum hCG level is an essential but not an exclusive criterion for the decision on treatment. Further
research is needed on how to treat patients with a serum hCG level between 2000 and 5000 IU/L with
no significant clinical symptoms and unremarkable ultrasound findings.

Keywords

Ectopic pregnancy; Methotrexate; hCG; Expectant management

Hrčak ID:

344728

URI

https://hrcak.srce.hr/344728

Publication date:

31.12.2025.

Article data in other languages: croatian

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