Abstract

A REVIEW ON METHOTREXATE AND ITS EFFECT ON PREGNANCY

Arif Muhammad A.*, Sowparnika Treasa Sabu and Prof (Dr.) Shaiju S Dharan

Abstract

Background: Methotrexate (MTX) is a folic acid antagonist and an anti-metabolite drug developed initially to treat certain types of cancer. It is the methyl derivative of aminopterin. It is used mainly in the treatment of certain cancers, severe psoriasis and also used at very low doses to treat rheumatic diseases. Methotrexate is cytotoxic to trophoblast and hence it causes abortion; even though, when methotrexate is used alone, abortion could take place in a mean 24 days after drug administration. Prostaglandin analogues, in general, increase the contractility of the smooth muscle in the uterus and cause expulsion of the foetus. Methods: Previously published articles regarding the methotrexate and it’s effect on pregnancy have been collected and reviewed. Observations: Methotrexate has been administered directly into the gestational sac for the conservative treatment of intra-tubal pregnancy for the past few years. In some other reports, the methotrexate was given by IM injection. Folic acid was also given along with this on the first day of each course or at the end of the treatment. Adverse effects those have been reported where elevated liver enzymes, as well as stomatitis, gastroenteritis, nausea, dermatitis myelosuppression and pleuritis. These side effects were much less common with single dose regimens.

Keywords: Methotrexate, Misoprostol, Pregnancy, Termination, Abortion.