{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:08:22Z","timestamp":1762866502094},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T00:00:00Z","timestamp":1413936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In the last three decades, systemic methotrexate (<jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>) has become widely accepted as the primary treatment for unruptured tubal pregnancy. This has prompted investigations into the use of <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> in the management of interstitial pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the effectiveness of methotrexate for treatment of interstitial pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed 17 haemodynamically stable women admitted to our tertiary, university\u2010affiliated medical centre with an intact interstitial pregnancy from January 2003 through February 2013. First\u2010line treatment consisted of intramuscular <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> 1\u00a0mg\/kg\/day x4 alternating with folinic acid 0.1\u00a0mg\/kg or, in cases of low beta\u2010human chorionic gonadotropin (\u03b2\u2010<jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content>) and no embryonic pole, one dose of 50\u00a0mg\/m<jats:sup>2<\/jats:sup> body surface area. Uterine artery <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> injection was administered on the ipsilateral side of the pregnancy followed by uterine artery embolisation as second\u2010line treatment. Failure criteria were &lt;15% decrease in \u03b2\u2010<jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> or sonographic evidence of pregnancy development. Second\u2010line failures were referred for surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve women (70.5%) underwent successful first\u2010line treatment and 5 (29.5%) required second\u2010line treatment. Baseline characteristics were similar except for a higher rate of two previous ectopic pregnancies in the first\u2010line failures (80% versus 8.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). Two women eventually required surgery, both with two previous ectopic pregnancies. Of the three women with fetal cardiac activity on admission, two had successful first\u2010line treatment and one required surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Systemic <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> is effective for treatment of intact interstitial pregnancy in haemodynamically stable women. The success rate is increased with uterine artery <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> injection as second\u2010line treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12251","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T08:23:17Z","timestamp":1413966197000},"page":"576-580","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Effectiveness of medical treatment with methotrexate for interstitial pregnancy"],"prefix":"10.1111","volume":"54","author":[{"given":"Liran","family":"Hiersch","sequence":"first","affiliation":[{"name":"The Helen Schneider Hospital for Women Rabin Medical Center Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haim","family":"Krissi","sequence":"additional","affiliation":[{"name":"The Helen Schneider Hospital 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