Journal of the European Society for Gynaecological Endoscopy


Management of tubal ectopic pregnancy with methotrexate in the setting of symptomatic Coronavirus disease 2019 (COVID-19): A case report

N.M. Millan 1, J. Morano 1, L. Florez 1, J. Carugno 1, C.A. Medina 1

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Miami, Health Systems, Jackson Memorial Hospital, Miami, Florida.


Methotrexate, ectopic pregnancy, coronavirus

Published online: Sep 24 2021


Background: Coronavirus Disease 2019 (COVID-19) represents a complex therapeutic challenge. As the pandemic progresses, patients are presenting with ectopic pregnancies (EPs) and symptomatic COVID-19.

Objective: We present the management of a patient with multiple medical comorbidities and tubal EP in the setting of severe symptomatic COVID-19 infection where all management options were precluded.

Methods: Case report with literature review of management of tubal EP in the setting of severe symptomatic COVID-19 infection.

Result: After careful consideration of options, the patient underwent successful medical management with methotrexate while receiving supportive care for COVID-19.

Conclusions: Methotrexate proved to be the safest therapeutic option in this patient. Management of patients with severe COVID-19 and gynaecologic emergencies should be individualised and carefully reviewed with evolving knowledge of COVID-19.