Combination Of Methotrexate And Mifepristone Versus Methotrexate Alone For Ectopic Pregnancy Treatment: A Systematic Review

Objective To compare the curative effect and adverse effect between the combination of methotrexate and mifepristone and methotrexate alone for ectopic pregnancy treatment. Methods By searching Pubmed, FMJS, Cochrane Library, Ovid, CBM, CNKI, VIP, Wangfang, we collected randomized controlled trials between the combination of methotrexate and mifepristone and methotrexate alone for ectopic pregnancy treatment. Data were extracted and verified by two reviewers independently .We used RevMan 5.0.24 to perform meta-analysis. Results Fourteen RCTs involving 1449 patients were included.Meta-analysis showed that the combination of methotrexate and mifepristone comparing with methotrexate alone,the cure rate was higher than methotrexate alone(RR=1.20,95%CI 1.14~1.26,P<0.00001).The time of HCG resolution(MD=-7.57,95%CI -8.42~-6.73,P<0.00001),mass disappearance(MD=-9.11,95%CI -16.39~-3.43,P=0.003) and length of stay (MD=-4.0,95%CI -6.84~-1.16,P=0.006)was less than methotrexate alone.The rate of second dose was lower than methotrexate alone ( RR=0.56 , 95%CI 0.35~0.92 ,P=0.02 ) ,and adverse effect had no difference. Conclusion The combination of methotrexate and mifepristone is better than methotrexate alone for ectopic pregnancy treatment.It is safety and effective.