[Three-dimensional ultrasound evaluation of the efficacy and safety of single-dose systemic or local methotrexate injection for tubal pregnancy].

Objective: To compare the efficacy and safety of single-dose systemic and local injection of methotrexate (MTX) in the treatment of tubal pregnancy (TP).

Methods: The systemic group included 127 women with TP who received a single-dose MTX of 50 mg/m(2) given by intramuscular injection, and the local group included 118 women receiving single-dose MTX of 100 mg via local injection guided by three-dimensional (3D) ultrasound. The volume of ectopic masses and blood beta-human chorionic gonadotropin (beta-HCG) were measured before and after MTX administration. The TP was detected by 3D images reconstructed 3 months after MTX administration.

Results: The success rate of treatment was 100% in the local group, significantly higher than that of 91.34% in the systemic group. After the first week of MTX injection, the speed of the ectopic mass resolution was 0.85+/-0.04 cm(3)/d and 0.47+/-0.03 cm(3)/d in systemic group and local group respectively (P<0.05), and the time of the ectopic mass resolution was 27.66+/-12.77 d and 32.62+/-12.75 d, respectively (P<0.01). The rate of tubal deformity in the local group was significantly lower than that in the systemic group.

Conclusion: Local injection of MTX under ultrasound guidance is safe, efficient and reliable for conservative management of unruptured TP, which is superior to systemic injection.