- In ectopic pregnancy, the magnitude of human chorionic gonadotropin (hCG) decrease with methotrexate (MTX) treatment can help assess patient risk and reduce follow-up time.
Why this matters
- MTX is used for the treatment of ectopic pregnancy at a rate of up to 27% in the US.
- Observational cohort study of MTX (1 mg/kg) for ectopic pregnancy.
- Day 1 (D1) was day of injection.
- With hCG drop ≤20% from D1 to D4, women were assigned to high-risk group.
- Low-risk women (n=151) underwent hCG testing on D28.
- D28 hCG ≤15 mUI/mL confirmed successful treatment.
- High-risk women (n=274) tested at D7 and then weekly; decline of hCG from D4 to D7 or weekly was
- Outcome measures were success rate, proportion of women requiring multiple injections, and mean number of consultations per women and duration of follow-up.
- Funding: None.
- In the low-risk group, success rates were higher, with fewer doses of MTX and follow-up visits needed.
- Success rate after a single dose was 89.9% in low-risk vs 76% in high-risk group.
- Failures in low-risk group: 5 surgical treatments between D4 and D7 and 1 at D38.
- This protocol would occasionally delay follow-up for MTX failure.