{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T23:20:14Z","timestamp":1782343214050,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,4,21]],"date-time":"2018-04-21T00:00:00Z","timestamp":1524268800000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The aim of this study was to compare ultrasound\u2010guided local methotrexate (<jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>) vs. systemic methotrexate in uterine ectopic pregnancy regarding the beta human chorionic gonadotropin (<jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content>) clearance duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Patients with interstitial pregnancy, cervical pregnancy or cesarean scar pregnancy were included. Methotrexate was administered locally ultrasound\u2010guided (25\u00a0mg methotrexate fixed dose) or systemically (intramuscular; 50\u00a0mg\/m<jats:sup>2<\/jats:sup> body weight). Beta <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> clearance duration in days formed the main outcome measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six patients with uterine ectopic pregnancy were included. The mean estimated beta <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> clearance duration was 29.2\u00a0days longer in patients with local methotrexate compared with systemic methotrexate (64.7 vs. 31.5\u00a0days, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.026). There was no significant difference between local vs. systemic methotrexate regarding adverse events such as bleeding (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.376), pain (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.146) or secondary surgery (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.631). There was no association of initial beta <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> levels (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.746), initial progesterone levels (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.870) or patients\u2019 age (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.604) and the beta <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> clearance duration. No significant difference in beta <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> clearance duration comparing local methotrexate injection with aspiration vs. local methotrexate injection without aspiration could be found (mean 49.4 and 71.6\u00a0days, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.225).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with uterine ectopic pregnancies, the mean estimated beta <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> clearance duration was 29.2\u00a0days longer when applying local methotrexate compared with systemic methotrexate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13348","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T07:32:58Z","timestamp":1522135978000},"page":"824-829","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Management of uterine ectopic pregnancy \u2013 local vs. systemic methotrexate"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4748-2994","authenticated-orcid":false,"given":"Marianne","family":"Koch","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria"},{"name":"Karl Landsteiner Society St. P\u00f6lten Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Joseph Hospital Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Meyer","sequence":"additional","affiliation":[{"name":"Center for Medical Statistics, Informatics, and Intelligent Systems Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana","family":"Montanari","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Bader","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Ott","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Helmy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria"},{"name":"Karl Landsteiner Society St. P\u00f6lten Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0810384"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3182516d7b"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.12.3224"},{"issue":"1","key":"e_1_2_8_5_1","first-page":"1","article-title":"Saving Mothers\u2019 Lives: reviewing maternal deaths to make motherhood safer: 2006\u20132008. 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