RESUMEN
Objective: To evaluate the success of systemic single-dose methotrexate [MTX] treatment in patients with ectopic pregnancy [EP] and to investigate factors related to treatment success
Methods: This retrospective study had been performed in Yildirim Beyazit University between January 2010 and December 2015. Demographic and clinical characteristics, ultrasonografic findings, pretreatment serum beta-human chorionic gonadotropin [beta-hCG] and progesterone levels of 58 patients with EP were retrieved from hospital records retrospectively. The patients were grouped according to MTX treatment success [response vs. failure]
Results: Single-dose MTX-treatment was successful in 72.4% [42/58] of patients. The mean pretreatment beta-hCG level was significantly lower in responders than in failures [2080 +/- 2322 vs. 5707 +/- 3885 IU/L, p = 0.001], and 2678 IU/L was the most suitable cutoff to predict success [75% sensitivity, 73.8% specificity]. Moreover, failure rate was 8.45 times more in group of patients whose beta-hCG values were determined above the cutoff. The presence of fetal cardiac activity adversely affected treatment success [odds ratio = 12, p = 0.004]. Treatment success was not affected by past history of ectopic pregnancy, thickness of endometrium, progesterone value or presences of pseudosac and free pelvic fluid
Conclusion: The success rate of single dose MTX in this study was 72.8 %, and we found that failure rate of MTX treatment was 8.45 times more in group of patients whose initial serum beta-hCG values were above 2678 IU/L and 12 times more in patients with fetal cardiac activity