(Zorzela 2014; Loke 2011; (Higgins 2011).)(For this review I will consider them all.) The adverse events of Methotrexate are related to body weight especially if more than one dose is used. These are- (Pfeifer 2013;Elson 2016;Hajenius 2009;Song 2016)
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Treatment side effects Drug side effects
Increase in the width of the abdomen Stomach irritation; Nausea; vomiting
Increase in HCG at the start of treatment Mouth Ulcers
Bleeding and spotting vaginally. Dizziness
Tummy pains Severe fall in white blood cell counts. Hair loss Inflammation of the lungs.
No guideline or systematic reviews ( Cecchino 2013; Elson 2016; Hajenius 2009; Kumar 2016; Mol 2008; Pfeifer 2013; NICE …show more content…
If not, I will consider RCTs and comparator 2. (keeping in mind language restrictions) If these are not helpful, I will look for observational studies and comparator 1 and then with comparator 2. Lastly, I will proceed to include extra tubal ectopic in the same order as above.
Objectives
1. I want to identify the rates and percentages of treatment associated short term adverse events (AEs) reported with systemic Methotrexate use in ectopic pregnancy through a systematic review of all available RCTs. If the evidence is not available from RCTs I will include well designed observational cohort and case control studies.
(Risks/complications/adverse events/adverse reactions.)
2. I want to look for an association (and its strength) between each AE and Methotrexate.
3. To see if these AEs are dose related. (i.e. 50 mg/m2 surface area doses vs others).
4. I want to assess AE’s alone and not with beneficial effects...
5. I don’t want to consider costs.
6. I don't want to look at other types of pregnancy conditions where this drug is used. (e.g. medical termination of pregnancy