Can Methotrexate Induce Tubal Abortion?:
A Report of Three Cases

Murat DEDE, Ümit GÖKTOLGA, Müfit Cemal YENEN, Namık Kemal DURU, Tansu KUCUK, İskender BAŞER
Ankara-Turkey

To report tubal abortion observed in laparoscopy in three tubal ectopic pregnancy cases. Laparoscopic evaluation has been made for sudden pelvic pain suggesting of clinical tubal rupture symptoms on third day following single dose of IM Methotrexate (50 mg/m2) injection. Tubal abortion was observed in all three cases with no tubal rupture at laparoscopy (1) Tubal abortion may be a result of extraction of ectopic pregnancy material by tubal peristaltism from the fimbrial end, which was lysed and gotten smaller by the antimetabolic affect of methotrexate. (2) Surgical intervention may be delayed even if the clinical symptoms of tubal rupture had occurred and expectant management with close observation should be a suitable way of follow up for these patients because of tubal abortion probability.
(Gynecol Obstet Reprod Med 2005; 11:64-65)

Key Words: Ectopic pregnancy, Methotrexate, Tubal abortion