Role of routine monitoring of Liver and Renal Function during treatment of ectopic pregnancies with single-dose Methotrexate protocol

Capsule:
Routine measurement of serum aspartate aminotransferase and creatinine levels may not be necessary before instituting a single-dose methotrexate protocol for the treatment of ectopic pregnancy.

Authors:
Lindsay E. Clark, M.D., Bala Bhagavath, M.D., Carol A. Wheeler, M.D., Gary N. Frishman, M.D., Sandra A. Carson, M.D.
Volume 98, Issue 1 , Pages 84-88.e1, July 2012

Objective:
To assess whether or not baseline serum transaminases and creatinine measurements, before administration of methotrexate, identified significant liver or kidney disease, which have the potential to alter the management plan for the treatment of ectopic pregnancies.

Design:
This is a retrospective study of patients treated for ectopic pregnancy.

Setting:
Women’s emergency room and reproductive endocrinology office at a teaching hospital over a 3-year period.

Patient(s):
Women presenting for treatment of ectopic pregnancy.

Intervention(s):
None.

Main Outcome Measure(s):
Assessment of baseline serum transaminases and creatinine measurements before administration of methotrexate to identify significant liver or kidney disease.

Result(s):
A total of 383 patients were managed for ectopic pregnancy from January 2006 to December 2008. Of these, 320 patients received methotrexate as part of their treatment. No patient was denied treatment with methotrexate secondary to concerns regarding liver or renal function. No complication related to methotrexate administration was documented. A subgroup of 81 patients had pre- and postadministration labs, and no significant difference was noted upon comparing the values.

Conclusion(s):
Routine measurement of serum aspartate aminotransferase and creatinine levels may not be necessary before instituting a single-dose methotrexate treatment regimen for the management of ectopic pregnancy.

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