Some aspects of drug treatment of ectopic pregnancy

Background. Today drug treatment of tubal pregnancy with methotrexate is a real alternative to endoscopic salpingectomy in patients who have not realized their reproductive function. This article presents a statistical analysis of clinical data based on the case histories of patients with ectopic pregnancy who were treated in Ternopil municipal hospital №2 for 2010–2017. Objective of the study was to determine the homocysteine, folic acid, alkalinephosphatase, aspartate aminotransferase, alanine aminotransferase, common bilirubin levels in patients with progressive ectopic pregnancy, treated with different doses of methotrexate. Materials and methods. Group I (30 women) included patients with an ectopic pregnancy who were treated intramuscularly with methotrexate (100–75 mg) once, and patients of group II (30 women) received additional 100–75 mg of methotrexate after 7 days. The control group consisted of 30 healthy women. Results of the study. Twice administration of methotrexate at 7th day leads significant transient increase of aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase. Once-daily use of methotrexate has no cytolytic effect on the liver cells, does not change the alkaline phosphatase and total bilirubin level. Homocysteine in the blood plasma for both 7th and 30th days increased with the use of the dose-dependent methotrexate. The folic acid level on the background of the methotrexate is significantly decreased. Conclusions. Patients with progressive ectopic pregnancy with its accurate diagnosis should be offered conservative drug treatment, which will preserve the reproductive function of women in the future. In women who underwent medical treatment with cytostatic it is recommended the obligatory control of blood biochemical parameters and evaluation of homocysteine, folic acid as factors that are clinically significant and may indicate a violation of the folate exchange. Folic acid recommended throughout the period of the preparation for next pregnancy to normalize laboratory parameters