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Comparison of the success rates of a single dose and an additional dose of methotrexate on the 4th day in patients whose β-hCG values do not fall after a single dose of methotrexate (Day 0-4).
- Source :
-
Journal of gynecology obstetrics and human reproduction [J Gynecol Obstet Hum Reprod] 2024 Oct; Vol. 53 (8), pp. 102811. Date of Electronic Publication: 2024 Jun 05. - Publication Year :
- 2024
-
Abstract
- Introduction: This study's aim is to investigate whether the rise in β-hCG levels between days 0 and 4 in patients with tubal ectopic pregnancy who have received a single dose of methotrexate has prognostic value in treatment success, and to investigate whether administering a second dose on day 4 enhances treatment success.<br />Material and Methods: Patients diagnosed with ectopic pregnancy and experiencing an increase in β- hCG levels on day 4 after initiation of methotrexate treatment were included in our study. Patients treated with a single dose Methotrexate (MTX) protocol until December 2019 were retrospectively screened from January 2018 to December 2019. Patients receiving a second dose on day 4 until September 2021 were prospectively enrolled from January 2020 to September 2021. A decrease of over 15 % in the β-hCG value after the 4th dose was considered as treatment success.<br />Results: Treatment success rates were compared between these two groups. 115 patients with ectopic pregnancy were included in the study. A single dose methotrexate protocol was applied in 67 of the patients (Group 1), while an additional dose methotrexate was applied in 48 (Group 2). The treatment was successful in 40 patients (59.7 %) in Group 1 and in 39 patients (81.3 %) in Group 2. The success rate of the treatment was significantly higher in patients who received an additional dose methotrexate protocol (p = 0.014).<br />Discussion: This study shows that; it is possible to increase success rates by applying an additional MTX dose on the 4th day in cases with an increase in β-hCG on the 4th day.<br />Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Humans
Female
Pregnancy
Adult
Retrospective Studies
Treatment Outcome
Pregnancy, Ectopic drug therapy
Pregnancy, Ectopic blood
Drug Administration Schedule
Methotrexate administration & dosage
Methotrexate therapeutic use
Chorionic Gonadotropin, beta Subunit, Human blood
Abortifacient Agents, Nonsteroidal administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 2468-7847
- Volume :
- 53
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of gynecology obstetrics and human reproduction
- Publication Type :
- Academic Journal
- Accession number :
- 38844087
- Full Text :
- https://doi.org/10.1016/j.jogoh.2024.102811