Assessment of early decline in percentage of β-hCG values between days 0 and 4 after methotrexate therapy in ectopic pregnancy for prediction of treatment success

Abstract

OBJECTIVE: To evaluate percentage changes in serum beta-human chorionic gonadotropin (β-hCG) values between days 0-1, 0-4 and 0-7 as an indicator of methotrexate therapy success in extra-uterine pregnancies. MATERIAL AND METHODS: Women with ectopic pregnancy treated with single-dose methotrexate therapy between January 2011 and August 2012 were assessed. Recorded data were reviewed electronically from patient files. All women (n=93) with an ectopic pregnancy treated medically with intramuscular methotrexate (50 mg/m(2)) were included. The percentage changes in serum β-hCG levels from day 0 to 1, day 0 to 4 and day 0 to 7 were calculated for each case. RESULTS: The median β-hCG values decreased between days 0 and 4 by 55.8%, and 89.6% of these cases were treatment successes. The median initial serum β-hCG values were lower in women with successful treatment, but this was not statistically significant (p=0.11). CONCLUSION: A decline in serum β-hCG values between days 0 and 4 appears to be the best predictor. It would be beneficial to determine whether a woman with an ectopic pregnancy treated with single-dose methotrexate administration will be treated successfully.