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Purpose Methotrexate is a treatment option for ectopic pregnancy. Women who have utilized Methotrexate could need repeated doses or undergo an operation during follow-up. We aimed to evaluate the parameters that could affect Methotrexate success and to determine patients who could benefit from early doses of Methotrexate. Methods This retrospective study was conducted with 439 patients diagnosed with tubal ectopic pregnancy. Women treated with Methotrexate successfully and patients need a second dose of Methotrexate or who underwent an operation were evaluated. Clinical, sonographic and laboratory findings were compared between groups. Results A total of 259 patients were urgently operated and 37 of them were operated on after Methotrexate. The number of patients treated successfully with single dose Methotrexate was 102, on days 1 and 7 administered Methotrexate was 22, and on days 1 and 4 administered was 19. The mean admission β-hCG level and day 4 to 1 β-hCG ratio were significantly different between operation and Methotrexate groups. The overall Methotrexate success was 79%. A β-hCG value of 2255 mIU/ml predicted the success with specificity of 68.5% and sensitivity of 70.3%. Comparison of groups with single-dose, additional dose, or operation exposed that day 4 to 1 β-hCG ratio was statistically different. A ratio of 95.5% predicted the success with a specificity of 72.5% and a sensitivity of 84.7%. Conclusion We suggest that the determination of the β-hCG level might help decide whether the patient should be hospitalized. Moreover, day 4 to 1 β-hCG ratio could be used for early intervention to increase treatment success. |
