Medical Management of Ectopic Pregnancy: A Case Report from Ile-Ife, Nigeria

Abstract

Medical management of ectopic pregnancy using intramuscular methotrexate is a well-known, highly effective and non-invasive option of treatment of unruptured ectopic pregnancy. Its role is expanding worldwide due to the increased incidence of ectopic pregnancy and improvement in early diagnosis with the aid of beta-hCG assay and transvaginal ultrasound scan. With the advent of assisted reproductive techniques and improved diagnosis of unruptured ectopic pregnancy in Nigeria, the role of medical management of ectopic pregnancy in the country is likely to increase. We present a 38-year-old primipara with an unruptured right tubal ectopic pregnancy who fulfilled the eligibility criteria for medical management. She had single-dose intramuscular methotrexate but required a second dose due to a suboptimal fall in hCG levels between days 4 and 7. She tolerated both doses well and her hCG had become undetectable by the fifth week.