What are some absolute contraindications to the use of Methotrexate (MTX) for ectopic pregnancy?

Methotrexate (MTX) is a folate antagonist used in the medical management of ectopic pregnancies. Understanding the absolute contraindications is vital for patient safety and successful treatment.

In the case of an intrauterine pregnancy (IUP), administering MTX is contraindicated since it could harm the developing fetus. Immunodeficiency presents a risk because MTX can further suppress the immune system, potentially leading to severe infections. Severe anemia can compromise a patient’s physiological reserve and overall health, making the use of MTX inadvisable due to the risk of further exacerbating the condition.

Each of these conditions emphasizes the patient’s vulnerability and the potential for MTX to cause significant harm; thus, they are recognized as absolute contraindications. Other options include contraindications that may not be absolute or could represent caution rather than outright prohibitions. For example, while hepatic dysfunction is a significant concern in the use of MTX, it does not automatically preclude its use depending on the severity and clinical context. Ruptured ectopic pregnancies often require surgical intervention rather than medical management. The other conditions listed may warrant careful evaluation and may not completely rule out the use of MTX in all circumstances.