Systematic review and meta-analysis of single-dose and non-single-dose methotrexate protocols in the treatment of ectopic pregnancy

Jin Sung Yuk, Jung Hun Lee, Won I. Park, Hyeong Sik Ahn, Hyun Jung Kim

Research output: Contribution to journalReview articlepeer-review

10 Citations (Scopus)

Abstract

Background: It remains unclear which methotrexate protocol for the treatment of ectopic pregnancy has a higher success rate or a higher adverse effect rate. Objective: To compare the treatment success rates and adverse effect rates of single-dose and non-single-dose (two-dose and multi-dose) methotrexate protocols in the treatment of ectopic pregnancy. Search strategy: Various databases including Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched on July 1, 2017, using search terms including “methotrexate” and “pregnancy.”. Selection criteria: Randomized controlled trials comparing different methotrexate protocols for the treatment of ectopic pregnancy were included. Data collection and analysis: Relative risks (RRs) and 95% confidence intervals (CIs) were calculated to compare treatment success rates and adverse effect rates. Main results: The single-dose and non-single-dose protocols had similar success rates (RR 1.00, 95% CI 0.96–1.04; 11 trials, 1121 patients, I2=18%). The non-single-dose protocols had a higher adverse effect rate than did the single-dose protocol (RR 0.73, 95% CI 0.59–0.91; nine trials, 934 patients, I2=0%). Conclusions: The single-dose methotrexate protocol was the optimal protocol for the medical treatment of ectopic pregnancy.

Original languageEnglish
Pages (from-to)295-303
Number of pages9
JournalInternational Journal of Gynecology and Obstetrics
Volume141
Issue number3
DOIs
Publication statusPublished - 2018 Jun

Keywords

  • Ectopic pregnancy
  • Methotrexate
  • Multi-dose protocol
  • Single-dose protocol
  • Systematic review

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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