[Early diagnosis as a condition for conservative treatment of tubal pregnancy with methotrexate].

27 women with diagnosed unruptured tubal pregnancy were treated using methotrexate given intravenous. Three patients failed medical therapy and required surgical treatment for tubal rupture. The method was effective in 88,89% of cases. 17 women (63%) were given only one dose of methotrexate, ten others required 2-4 doses. Using the diagnostic algorithm (endovaginal sonography, serial B-hCG determinations and uterine curettage) the presence of an ectopic pregnancy was confirmed. The early and relatively easy to follow diagnosis allowing an increase in the proportion of patients who could undergo the alternative of methotrexate therapy and avoidance of laparotomy. The side effects of therapy were mild and transient. Because rupture of ectopic pregnancy can occur despite low and declining B-hCG levels, efficient monitoring was performed.