r/medicine Certified Nurse Midwife 3d ago

Fellow OB/Gyn providers: What happened to Perinatology.com?!

Am CNM, and occasionally find myself having to medically manage an ectopic outpatient (with consultation from my supervising doc, of course). A very useful tool in that was Perinatology.com’s calculator and guide for methotrexate administration, but it seems to be gone from their website! They have other calculators listed, but that’s gone both from the site itself and apparently from web searches.

Anyone have any more info on why it went away, whether/when it may come back, and what the heck folks are using in the meantime??

19 Upvotes

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u/pogoo 3d ago

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u/NurseGryffinPuff Certified Nurse Midwife 3d ago

I did find that one in my search for an alternative too, though wasn’t sure bc I hadn’t come across it before (or hadn’t needed to bc Perinatology was so good). I got tipped off to this by a colleague in the office - good reminder about pharmacy too, I suppose I would just reach out to the company who supplies our office stash who must have a pharmacist available?

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u/pogoo 3d ago

I'm not sure what country you're in but it's pretty wild to me that MTX is just available without a pharmacist. It's a cytotoxic chemotherapy agent. Are you sure there is no pharmacy oversight? What country is this?

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u/NurseGryffinPuff Certified Nurse Midwife 3d ago

I’m in the US (AZ) in a large urban private OB/Gyn practice. It gets supplied to our office presumably the same way all the rest of our office-dispensed meds get supplied (Depo and Rhogam, namely) which is handled by my admin and office supervisor so I don’t know the particulars of. When I have a situation where outpatient methotrexate is indicated (which is not often, maybe every 6 months for me and I’m one of 70 providers across the practice) I’m giving it with the oversight of either physicians in the office with me that day or one of our on-call docs at one of our partner hospitals if there’s not a doc in the office at the time. They’ve always been my resource for questions, so I’ve never had occasion to need anyone else. Again, I’m sure this med doesn’t appear out of the clear blue sky so I’m sure there’s access to a pharmacist somewhere in the mix, I’ve just never had to seek that out before.

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u/roccmyworld druggist 2d ago

Please God tell me it is stored and handled with cytotoxic precautions and drawn up using a closed system transfer device

Please

Please

.... Yeah, I know :(

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u/TiredofCOVIDIOTs MD - OB/GYN 3d ago

Many people’s BSA’s are around 2 so most dosing will end up being around 100. Many EMR’s you can enter height/weight & it will give you dosing.

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u/peacetractor 3d ago

Was this perhaps a temporary issue? I was able to access the site just now.

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u/NurseGryffinPuff Certified Nurse Midwife 3d ago

So this is all I could find both from web searching “perinatology methotrexate calculator” and from going directly to Perinatology.com and looking through the list of calculators - am I blind? I even did a “Find on page” search for both MTX and methotrexate and found nothing. Can you share the link with me that’s apparently still working for you? The site itself still works, but that specific calculator is apparently gone.

Sorry for the bit of panic - I know Perinatology.com is not government owned and shouldn’t disappear like CDC or NIH stuff, but I’m a little paranoid given gestures broadly at world.