Comparison of success rates in the medical management of ectopic pregnancy with single-dose and multiple-dose administration of methotrexate: a prospective, randomized clinical trial

ObjectiveTo assess whether success rate differs in single-dose versus multiple-dose administration of methotrexate (MTX) in medical management of unruptured ectopic pregnancies.DesignProspective randomized clinical trial.SettingTertiary university hospital.Patient(s)The study population included 108 patients presenting with unruptured ectopic pregnancies who fulfilled the criteria for medical management.Intervention(s)A single dose (study group) or multiple doses (control group) of MTX were administered IM.Main Outcome Measure(s)Success rate of medical management in each group.Result(s)Of the 54 patients on the single-dose protocol, treatment was considered successful in 48 patients (88.9%). Of the 54 patients on the multiple-dose protocol, 50 participants responded to the treatment (92.6%). The difference between success rates in the two groups was not statistically significant (P=.7; odds ratio 0.64; 95% confidence interval 0.17–2.4). In the single-dose and multiple-dose groups, 15 (27.8%) and 20 (37%) patients, respectively, had complications (P=.3).Conclusion(s)The results of our study showed that single-dose treatment with MTX could be as successful as multiple doses. The incidence of complications did not differ between the two groups. It appears that single-dose treatment could be the first line of treatment in selected patients.