# methotrexate?



## hvl25 (Jan 28, 2003)

I have a friend that had an ectopic pregnancy and they gave her methotrexate. She has had a bad reaction to it. She went in to have an ultrasound because she has been in pain ever since and they told her she had ovarian cysts and they would do lathroscopy to find out how bad they were. They did the surgery Saturday and found pooling blood in her uterus/ovaries? found that an ovary had attached to her bowel and that basically the doctor said the right tube was destroyed and that if she had another ectopic pregnancy on that side they would have to remove the tube totally and she has an increased risk because she has already had one. She posted on parentsplace at ivillage but I wanted to check out here, something less mainstream and pro medical/drs Anyone have any information on this? When I looked it up it says it is a cancer drug/chemotherapy and not FDA approved for other uses. Please help me get my friend some answers/info on this drug.


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## Lucky Charm (Nov 8, 2002)

Quote:

When I looked it up it says it is a cancer drug/chemotherapy and not FDA approved for other uses
Interesting.
Methotrexate is used to end ectopic pregnancies as long as certain criteria are met, for instance the pregnancy can only be a certain amount of weeks, and the fetus' heart rate must be below a certain number. for instance, in the ER, we see quite a few ectopic pregnancies. about 1/2 go to the OR to end it. one woman i sent was about 6 weeks and the fetus had a heart rate greater than 150bpm, so she wasnt a methotrexate candidate. another woman got the methotrexate because her baby had no fetal heart motion and her pregnancy measured less than 5 weeks. does this make any sense?

methotrexate is also used to treat Rheumatoid Arthritis. Not all cases of course, but my MIL takes it, and i briefly worked in a rheumatologists office and quite a few of the patienst were on it.

I cant explain the ovary/intestine thing. she could have some free fluid in her abdomen secondary to a ruptured ovarian cyst. i cant speculate.

I am so sorry about your friend.


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## KatherineinCA (Apr 4, 2002)

I received a dose of methotrexate for my ectopic pregnancy. I had already had two emergency surgeries in the previous four weeks, and my hcg was still rising. At that point, they decided to try the drug. It did work.

The odd thing was that it made me so nauseous, but when I mentioned it to the doctor, he said that methotrexate doesn't cause nausea. Well, gee, of course it doesn't if the doctors shrug it off when the patients report it as a side effect! And aren't chemotherapy drugs notorious for causing nausea? It seems like it wiped me out for quite some time (in terms of fatigue and grogginess), but that could also be the two surgeries so close together, too.

From all that I've seen, read and heard, it's not at all unusual to use it for ectopic pregnancies. For a situation like mine, it was certainly better than another failed surgical attempt.

If your friend needs to connect with others who've been through an ectopic pregnancy, feel free to PM me. I found that the loss of the pregnancy was compounded by the potential loss of future fertility, as well as the trauma of the excruciating physical pain and the emotional turmoil of an emergency situation. It's a lot to process.

Katherine


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## 1jooj (Apr 8, 2002)

I had it for an ectopic too. I was 7 weeks, my hcg levels were already dropping, and I don't know about the heartbeat--the OB on call in my doc's office, I think to spare me, pointed the u/s screen away from me.

I was totally wiped for a while--at least a week--and I was nauseated for a day or two. I am sure blood loss contributed to these as well.

I think they are using it more and more for ectopics because it may actually lessen the chance of scarring, improving odds of successful conception. It is also less invasive, requires no OR or anesthesia...that said, I had to wean my ds, which was really tough at that moment, and the bleeding started so suddenly and soon after the shot, it freaked me out. The way it works, as I understand, is by arresting the growth of fast-growing tissues (like a fetus or a tumor, which multiply faster than other tissues). This causes the fetus to die, and separate from the maternal tissues, at which point her body should expel it.

I know in my reading there was something referred to as "methotrexate pain," and the process of expelling all the tissue was painful for me. Hot baths and rest, and tylenol, helped. I also had some blood pooling which caused pressure and bowel pain, which also freaked me out--but that was from the ectopic, and not the treatment.

Like Katherine said, it's a lot to process. An ectopic is scary. It's life-threatening, and the pain involve sends that message loud and clear. It's also intensely personal and profound, and I found it really hard for others to relate--it was not just the loss of the pregnancy, but having a "near-miss" for myself at the same time, that made the feelings so hard to navigate at times. The weekly trips to the lab for hcg counts were hard to endure too, but hitting the level of 2 was like closing a book. I was so ready by then.

I also had mine at the 30-year anniversary of Roe v. Wade, when every newspaper was discussing abortion and people's opinions about the morality of the subject.

On the bright side, the half life of the med is not so terribly long. In a few months, she can probably try again if everything else is OK. (I had methotrexate in Jan, and I am due in December.) But in the meantime, she needs good friends to offer her a lot of support and make sure she nourishes herself. Does she have endometriosis? Also make sure she is checked for infections, which could contribute to scarring...

You're a good friend to try to help.


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## hvl25 (Jan 28, 2003)

thank you for giving me some information. I am going to pass this thread onto her. Thanks for all y9our help.


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