Methotrexate for Ectopic Pregnancy

Becoming a mother is a blessing in itself. However, some complications such as, ectopic pregnancy can make this blessing more of a curse that can cost you your life, if not paid attention on time. Ectopic pregnancy is a condition wherein the fertilized egg implants itself out of the uterus, thereby referring to the pregnancy as ectopic meaning 'out of the place'. An ideal pregnancy is when the fertilized egg implants itself within the uterus, which has enough nurturing tissues and space for the ideal growth of the fetus. However, due to complications and errors in the reproductive physiology, the implantation takes place in places like the fallopian tube, ovary, cervix, or the abdomen. More than 95% cases of ectopic pregnancies occur when the implantation takes place in the fallopian tube. This can prove to be life-threatening for the mother as the growth of fetus may make the organ burst causing heavy bleeding and other internal complications. As far as the baby is concerned, most of the ectopic pregnancies do not lead to a live birth. However, the placenta cells end up multiplying rapidly, putting the mother under risk. Which is why it is very important to end the ectopic pregnancy as early as possible.

How is Methotrexate useful for Ectopic Pregnancy?

Methotrexate is a drug which has antifolate properties which makes the immune system of the body less active. See, when you are pregnant, the body uses certain essential vitamins known as folate to divide the cells rapidly for the growth of the fetus. However, because in case of ectopic pregnancy, you want the fetus to stop growing, the antifolate properties of methotrexate is used to stop the cells from rapidly dividing themselves. Apart from ectopic pregnancy, this drug is used to treat conditions like psoriasis, rheumatoid arthritis, and certain types of cancer cell growth. However, let us get back to how methotrexate can prove to be beneficial for treating ectopic pregnancy.

Can You Use Methotrexate for Treating Ectopic Pregnancy?
Though this drug is used for treating this condition, not all women are eligible to consume this drug as the side effects of methotrexate can prove to be extremely bothersome. For your doctor to be able to treat you with this drug, you need to fulfill the following criteria.

• Your pregnancy hormones known as human Chorionic Gonadotropin (hCG) should be low, ideally less than 5,000 mlU/ml.
• Your pregnancy is not more than 6 weeks old.
• The fallopian tube is not ruptured and there is no other form of abdominal bleeding.
• The embryo doesn't have an heart activity.
• Also, the mother should be healthy and should not be suffering from conditions like kidney and liver problems, HIV/AIDS, anemia, peptic ulcer and any other form of active infection.

How is Methotrexate used for Ectopic Pregnancy?
Well, you may consume this drug either orally or in the form of injections. Usually injections are more effective for this purpose as compared to oral consumption. A single methotrexate injection would be given to you. The success of the treatment is evaluated by monitoring your hCG levels. Your doctor would probably check these levels before giving you the injection. The drug takes time to lower the hCG levels further more, so your doctor would keep checking your hCG levels within a gap of 2-3 days. Weekly monitoring of the hCG levels are done unless they are low enough to conclude that the pregnancy has successfully ended. If the first dosage fails to bring the levels down, your doctor might give you another dosage. Normally the entire procedure takes about a few weeks to a month, but it may also take up to 3 months depending from person to person. If the levels are still not low enough, your doctor may have to go for a surgery for removing the ectopic growth.

What are the Side Effects for using Methotrexate for Ectopic Pregnancy?
Well, the entire process for ending the ectopic pregnancy is surely not smooth and easy. The pregnant woman may go through various health related issues resulting from the consumption of this drug. These are listed as under.

• Abdominal pain will be experienced, especially during the first 2-3 days of treatment. There can be cramping and discomfort. However, you must inform your doctor about the degree of discomfort and pain that you are experiencing as it may be a sign of certain complications as well.
• You will suffer from bleeding and spotting from the vagina.
• Other side effects include nausea, indigestion, fatigue, dizziness and vomiting.
• There are also some more side effects that occur very rarely, although, it would be good for you to know. These side effects include sensitivity to light, dryness in the throat, hair loss, and low blood count.

It is good to opt for methotrexate treatment when you want to increase your chances of getting pregnant in the future. This is because, surgery can put you under the risk of permanent damage of the fallopian tube. It is also much less costlier as compared to surgery. However, you need to make it a point that you don't consume foods that increase gas in the abdomen like beans and cabbage. Keeping away from alcohol and smoking is also a must. Also try to keep yourself safe from sunlight as methotrexate can also cause light sensitivity, as already mentioned. Nevertheless, consulting your doctor is the best way to clear all your doubts.