Methotrexate is currently used in the U.S. to reat ectopic pregnancy where the tube has not ruptured. The mechanism of action is that this drug keeps cells from metabolizing folic acid. When injected into the sac, it causes the developing embryo to starve to death and die. Since the drug is a toxin to the fetus, some ethicists and religious leaders prohibit its use in treating ectopic pregnancy. The traditional treatment for ectopic pregnancy has been removal of the diseased portion of the fallopian tube with reconstruction of the tube to permit further attempts at fertilization.
Patients are blood-typed.
Second office visit - methotrexate is administered with prostaglandins given on the third and fourth office visit. Patients must stay in clinic 3-4 hours after receiving prostaglandin to evaluate for any side effects on the heart. It may take 24-26 days to fully pass the dead baby. Six of eight had complete abortions but it took 2 to 26 days to complete. Methotrexate does not kill immediately.