Efficacy of in-situ methotrexate injection in the treatment
The objective was the evaluation of the efficacy of different injection sites of methotrexate in the treatment of non-tubal ectopic pregnancies.

A total of 106 patients with non-tubal ectopic pregnancies, including 59 interstitial, 39 cesarean scars, and 8 cervical or isthmic were included. Fifty-eight patients received methotrexate via intramuscular injection (IM group), thirty-five received methotrexate via in-situ injection (IS group) and thirteen received a combination of both in-situ and intramuscular injections of methotrexate (IS+IM group).

- The primary success rate was 46.55% in the IM group, 60% in the IS group, and 61.54% in the IS+IM group respectively.

- In the multivariate analysis, the primary success rate of treatment was significantly correlated to the in-situ injection of methotrexate, either solely or in conjunction with an intramuscular injection of methotrexate administered the following day.

Solely an intramuscular injection of methotrexate is a less efficient first-line treatment strategy for the conservative management of non-tubular ectopic pregnancy. The use of an in-situ injection of methotrexate should therefore be preferred.

The Journal of Minimally Invasive Gynecology
Source: https://doi.org/10.1016/j.jmig.2021.08.007