Abstract

Introduction: Ectopic pregnancy is a serious cause of tubal loss or dysfunction among women in the reproductive age. Medical treatment is a commonly prescribed management under certain circumstances. It is associated with a high success rate, but tubal affection is a result. This study evaluated the effect of medical treatment on patients with unruptured tubal pregnancy.

Materials and methods: This was a prospective cohort study conducted at the Obstetrics and Gynecology Department of Suez Canal University Hospitals, from January 2016 to June 2019. We recruited Fifty- six patients with unruptured tubal pregnancy.All patients were managed with medical treatment, methotrexate therapy. After confirmation of successful medical treatment, hysterosalpingography was done three months after treatment for the evaluation of tubal patency.The outcome measure was the rate of tubal patency after medical treatment for unruptured tubal ectopic pregnancy.

Results: The present study revealed that 71.4% of patients (40 cases) had patent tubes, and 28.6% had blocked tubes. Moreover, 21.4% of patients have ipsilateral tubal block only, 3.6% have a contralateral tubal block, and 3.6% have a bilateral tubal block. Significant risk factors for tubal block were history suggestive of PID, acute PID hospitalization, and history of septic miscarriage (p value < 0.05).

Conclusion: Methotrexate provided successful fertility-preserving treatment for women with unruptured ectopic pregnancy, yet associated with tubal block.

Keywords

ectopic pregnancy, tubal ectopic pregnancy, risk factors, methotrexate, tubal patency, hystero-salpingography