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JCDR. 2021; 12(5): 476-488

The Aromatase Inhibitor “Letrozole” Versus Methotrexate for Management of Undisturbed Ectopic Pregnancy

Mostafa Mohamed Eltohamy, Amr Ahmed Abdelrahman, Ahmed Hasan Elmasarawy, Tarek Mohamed Elbeheidy.


Background: Ectopic pregnancy affects approximately 1% of pregnancies and is a leading cause of maternal
mortality in the first trimester. Timely and appropriate treatment of ectopic pregnancy is critical. Ectopic
pregnancy may be managed surgically, medically, or expectantly.
Aim of the Study: To evaluate the efficacy and safety of medical treatment of undisturbed ectopic pregnancy
either by Methotrexate or by aromatase inhibitors “Letrozole” treatment in order to Improve outcomes of
undisturbed ectopic pregnancy at Zagazig University Hospitals.
Patients and Methods: Randomized interventional clinical trial which was conducted in Obstetric and
gynecological department of Zagazig University Hospitals. The study included 48 patients who have
undisturbed ectopic pregnancy,Patients were randomly distributed into two equal groups (24 Methotrexate) (24
Letrozole); all patients were subjected toexamination (general, abdominal, pelvic): as regard pulse, blood
pressure, respiratory rate, evaluation of vital signs, measurement weight height (BMI), and Pelvic examination,
and also Investigations (Laboratory – Ultrasonography).
Results:According to the distribution of the studied patients regarding the results after treatment. Success in
Methotrexate Group reached 75%, while in Letrozole Group it reached 83.33%
Conclusion: This is a comparative, prospective, interventional, randomized clinical study that was conducted in
the Obstetrics and gynecological department of Zagazig University Hospitals. Our study showed a promisingly
high-resolution rate and better safety profile that Letrozole has compared with a chemotherapeutic agent such as
Methotrexate should encourage further studies.

Key words: Aromatase Inhibitor; Letrozole; Methotrexate; Ectopic Pregnancy

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