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Cutoff value of human chorionic gonadotropin in relation to the number of methotrexate cycles in the successful treatment of ectopic pregnancy.

Abstract：

OBJECTIVE:To assign cutoff values for human chorionic gonadotropin (beta-hCG) in pretreatment and after one methotrexate (MTX) cycle and determine its correspondence to the number of MTX cycles in successfully treated ectopic pregnancy. DESIGN:Retrospective study. SETTING:Polish university hospital. PATIENT(S):68 women with ectopic pregnancies who qualified for medical treatment. INTERVENTION(S):A single-dose of MTX (50 mg/m(2)) repeated every 7 days, plus laparoscopy in cases of tubal rupture or increased (>or=50% over 1 week) beta-hCG concentration. MAIN OUTCOME MEASURE(S):Resolution of serum beta-hCG without the necessity of laparoscopy. RESULT(S):Success rate was 78% (53 of 64 women). The medians of pretreatment beta-hCG levels in the groups treated successfully and unsuccessfully (943 vs. 3085 mIU/mL) and after the first dose of MTX (564 vs. 4049 mIU/mL) were statistically significantly different. The decrease in beta-hCG level after one MTX dose differed statistically significantly only in successfully treated women. The receiver operating characteristic (ROC) curve cutoff value in the success group indicated an initial beta-hCG level of 1790 and 1218 mIU/mL after one MTX cycle. The median of beta-hCG titer was not statistically different in patients requiring one or more treatment cycles. CONCLUSION(S):When the beta-hCG level is >1790 mIU/mL, the MTX treatment of ectopic pregnancy is at risk of failure. However, the initial beta-hCG titer is not a predictor of the number of MTX cycles that can guarantee a successful outcome.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Nowak-Markwitz E,Michalak M,Olejnik M,Spaczynski M

doi

10.1016/j.fertnstert.2008.07.1775

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1203-1207

issue

4

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(08)03295-0

journal_volume

92

pub_type

杂志文章

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