STUDY OF THE EFFECTIVENESS OF METHOTREXATE IN THE CLINICAL THERAPY OF ECTOPIC PREGNANCY IN A HOSPITAL IN WESTERN PARANÁ BETWEEN 2013 AND 2023

Abstract

Ectopic pregnancy is a major cause of first-trimester maternal morbidity and mortality. Methotrexate (MTX) is an effective non-surgical treatment option for hemodynamically stable and properly selected patients. This retrospective observational study aimed to evaluate the effectiveness of MTX in the clinical management of ectopic pregnancy in a hospital in Western Paraná between 2013 and 2023. Among the 52 identified cases, 14 patients received MTX, with a success rate of 78.6%. Higher initial β-hCG levels were associated with therapeutic failure (median ≈ 2129 mIU/mL), whereas successful cases had lower levels (≈ 900 mIU/mL). Fetal cardiac activity, present only in failure cases, was linked to worse outcomes. Adnexal mass size, pelvic free fluid, and gestational age showed no significant association with treatment failure. MTX demonstrated good efficacy and safety, reinforcing the relevance of strict selection criteria.