Retrospective analysis of factors that affect the success of single-dose methotrexate treatment in ectopic pregnancy. 2015

Altan Var, and Ramazan Özyurt, and Bulat Aytek Şık, and Serkan Kumbasar, and Erman Sever, and Mustafa Deveci, and Özgür Çöt, and Süleyman Salman, and Yılmaz Güzel
İstanbul Research and Education Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.

OBJECTIVE Detection of factors that affect the success of single-dose methotrexate treatment in ectopic pregnancy. METHODS We investigated 99 patients who had been treated with single-dose methotrexate for ectopic pregnancy in our clinic between January 2009 and June 2014. Demographic, clinical, and laboratory results of possible factors that affect treatment success were retrospectively analyzed. Successfully and unsuccessfully treated patients were compared based on their pre-treatment results. RESULTS The success rate of single-dose methotrexate treatment was found to be 70.7%. No significant difference was found between succesfully and unsuccessfully treated patients before treatment in terms of factors such as gestational weeks, mass size, presence of yolk sac, and presence of free fluid (p=0.224, p=0.201, p=0.200, p=0.200). Serum β-hCG values in patients whose treatment was unsuccessful was found to be higher compared with the successfully treated group (mean β-hCG value of unsuccessful group: 4412±3501 mIU/mL; mean β-hCG value of successful group: 1079±942 mIU/mL; p<0.001). CONCLUSIONS Single-dose methotrexate treatment is an effective and reliable method in the treatment of ectopic pregnancy. Elevation of serum β-hCG value stands as the main prognostic factor that affects the success of single-dose methotrexate treatment.

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