Rate of hourly change in serum beta-human chorionic gonadotropin levels in ectopic pregnancy can predict the success of treatment with single-dose methotrexate: A retrospective observational study

G. Lavie, M. Kais, R. Tendler, O. Marwan, J. Bornstein, A. Sharon

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: To determine whether the success of treatment with single-dose methotrexate (SD MTX) for ectopic pregnancy can be predicted using the rate of change in serum β-human chorionic gonadotropin (β-hCG) level. Study design: This was a retrospective observational study conducted at a tertiary referral centre. The study population included women who underwent treatment with SD-MTX for ectopic pregnancy. We analysed data of 119 women treated with SD-MTX for ectopic pregnancy at the Galilee Medical Centre between 2012 and 2016. Success was defined as a <15% decrease in β-hCG level between days 4 and 7, with no need for a second dose of MTX or surgical intervention. The dynamics of serum β-hCG levels before treatment were considered as the main outcomes. Results: SD-MTX administration was successful in 77 (65%) patients. The average baseline β-hCG level was significantly lower in women with successful outcomes than in those without successful outcomes (763.1 vs. 1429.63 mIU/L, respectively, p < 0.0048). The hourly change in β-hCG level was significantly lower in those with successful outcomes than in those without successful outcomes (0.38 vs. 5.73 mIU/mL, respectively, p < 0.0023). The percentage change in β-hCG level was 13.1%, which was not significantly different between the groups (p < 0.133). At serum β-hCG level < 946 mIU/mL and sac size < 2.55 cm, the treatment was successful in 88% of women. Conclusions: We propose a predictive model of hourly change in β-hCG to achieve successful treatment using SD-MTX in ectopic pregnancy based on objective and measurable criteria.

Original languageEnglish
Pages (from-to)39-43
Number of pages5
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume265
DOIs
StatePublished - Oct 2021

Bibliographical note

Publisher Copyright:
© 2021 Elsevier B.V.

Funding

We would like to thank Dr. Orly Yakir and Dr. Naama Wolf for their statistical assistance. This study was approved by the local Institutional Review Board (IRB) (approval number: 0002-18-NHR; date: 3/1/2018). All authors declare that the current study was not supported by any contributor and no grant was received.

Keywords

  • Ectopic pregnancy
  • Hourly change
  • Methotrexate
  • β-hCG

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