Single-dose methotrexate for the treatment of ectopic pregnancy: Our experience from 2010 to 2015

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 β-human chorionic gonadotropin (β-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 β-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 β-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 β‑hcg values were above 2678 iu/l and 12 times more in patients with fetal cardiac activity. © 2017 professional medical publications. all rights reserved.