An alternative treatment option in tubal ectopic pregnancies with fetal heartbeat: aspiration of the embryo followed by single-dose methotrexate administration

ObjectiveTo present 13 cases of unruptured tubal ectopic pregnancies successfully treated with ultrasound-guided aspiration and local and systemic methotrexate (MTX) administration.DesignCase series.SettingUniversity hospital.Patient(s)Thirteen women with an unruptured tubal ectopic pregnancy.Intervention(s)Transvaginal ultrasound-guided aspiration of the tubal ectopic pregnancy followed by MTX administration into the gestational sac (half of the calculated total dose of 25 mg/m2) and intramuscular injection (the remaining half of the calculated total dose of 25 mg/m2).Main Outcome Measure(s)Recovery of the patients, successful conservative treatment of the tubal ectopic pregnancies with preservation of the fallopian tubes.Result(s)Twelve (92%) of 13 women were successfully aborted, without need for salpingectomy or salpingostomy.Conclusion(s)Transvaginal ultrasound-guided aspiration of fetus followed by local and systemic methotrexate administration can be safely used to treat unruptured tubal ectopic pregnancies.