Methotrexate treatment in progressive tubal ectopic pregnancies and hCG‐related clinicosurgical implications

The Kaohsiung Journal of Medical Sciences - Tập 32 - Trang 317-322 - 2016
Askin Dogan1, Ibrahim Gulhan1, Ibrahim Uyar1, Atalay Ekin1, Cenk Gezer1, Muzaffer Bilgin2, Cüneyt E. Taner1, Ibrahim E. Ertas1
1Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Gaziler Street, Izmir, Turkey
2Department of Biostatistics, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey

Tóm tắt

AbstractOur aim was to evaluate the relationship between the success of methotrexate treatment and β‐hCG levels in progressive tubal ectopic pregnancies. We defined a retrospective cohort of 394 progressive tubal ectopic pregnancy patients treated with methotrexate. A single‐dose methotrexate protocol using 50 mg/m2 was administered to patients with progressive tubal ectopic pregnancy. Surgery was performed in patients who exhibited signs of acute abdomen due to tubal rupture. Of 394 patients that received methotrexate treatment, 335 (84.6%) responded to medical treatment, while the remaining 59 (15.36%) underwent surgery due to treatment failure. β‐hCG levels in the failure group were significantly higher as compared with the success group at Day 1, Day 4, and Day 7 (2116 ± 3157 vs. 4178 ± 3422, 2062 ± 3551 vs. 4935 ± 4103, and 1532 ± 3007 vs. 3900 ± 4783, respectively). The receiver operating characteristics curve for β‐hCG levels at Day 1 was 0.738, with a cutoff value of 1418 mIU/mL, while sensitivity and specificity values reached the optimum for treatment success (83.1% and 59.4%, respectively). Medical treatment with methotrexate achieved an 85.02% success rate for the treatment of progressive tubal ectopic pregnancy, while success rates for medical treatment decreased significantly when initial β‐hCG levels were >1418 mIU/mL.

Tài liệu tham khảo

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The Kaohsiung Journal of Medical Sciences

Tập 32

317-322

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