Transvaginal color doppler ultrasound in the conservative treatment and surveillance of three ectopic pregnancies.

We evaluated the role of transvaginal color Doppler ultrasound in the treatment and follow-up after transvaginal instillation of methotrexate in ectopic pregnancy. Three patients diagnosed with ectopic pregnancies were treated with a single 50 mg dose of methotrexate, transvaginally instilled, under direct color sonographic guidance. Inclusion criteria required a gestational age of less than 8 weeks, non-ruptured ectopic pregnancy, gestational sac of less than 4 cm, and compliant patient. b-hCG titers, gestational sac sizes, and Doppler flow waveform analyses were followed at regular intervals. All three patients had falling b-hCG titers, shrinkage of the gestational sacs, and normalization of Doppler flow waveform indices. Transvaginal color Doppler ultrasound appears to be an effective adjunct in the treatment and follow-up of ectopic pregnancies treated with transvaginal instillation of methotrexate.