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Middle East Fertility Society Journal
Middle East Fertility Society
ISSN: 1110-5690
Vol. 12, No. 1, 2007, pp. 57-62
Bioline Code: mf07010
Full paper language: English
Document type: Research Article
Document available free of charge

Middle East Fertility Society Journal, Vol. 12, No. 1, 2007, pp. 57-62

 en Single dose methotrexate for treatment of ectopic pregnancy: risk factors for treatment failure
Eskandar, Mamdoh

Abstract

Objective: To identify risk factors for single dose methotrexate (MTX) failure among patients treated for ectopic pregnancies. Design: Retrospective cohort.
Materials and methods: Seventy women diagnosed with an ectopic gestation treated with MTX. After a single dose, 66 (94.3%) patients experienced ectopic resolution, three (4.3%) patients needed a second dose of MTX, and one (1.4%) patient had a subsequent tubal rupture.
Main outcome measure(s): Predictive variables for failure of single dose MTX, including human chorionic gonadotropin (hCG) value, fetal sac size, patient age, parity and history of previous miscarriages.
Result(s): Ectopic pregnancies that failed to resolve following a single dose MTX were associated with increased maternal age, history of spontaneous abortions, larger sac sizes (>3.4 cm), and higher β-HCG levels (>2000 mIU/mL). Multiple regression analysis demonstrated that the size of the embryonic sac was the most important variable in failures of single dose methotrexate treatment.
Conclusion: Size of gestational sac and the pre-treatment level of HCG should be considered as independent risk factors for treatment failure of single dose methotrexate treatment.

Keywords
Ectopic pregnancy, methotrexate, human chorionic gonadotropin, embryonic sac size, tubal rupture.

 
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Alternative site location: http://www.mefsjournal.org

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