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The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center

OBJECTIVE: To study factors associated with the success of single dose methotrexate (MTX) treatment in women with ectopic pregnancy. METHODS: This is a retrospective study of women (n=110) with ectopic pregnancy and treated with single dose of MTX. The clinical presentations, transvaginal sonography...

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Autores principales: Sindiani, Amer Mahmoud, Alshdaifat, Eman, Obeidat, Basil, Obeidat, Rawan, Rawashdeh, Hasan, Yaseen, Hashem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764964/
https://www.ncbi.nlm.nih.gov/pubmed/33376413
http://dx.doi.org/10.2147/IJWH.S279426
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author Sindiani, Amer Mahmoud
Alshdaifat, Eman
Obeidat, Basil
Obeidat, Rawan
Rawashdeh, Hasan
Yaseen, Hashem
author_facet Sindiani, Amer Mahmoud
Alshdaifat, Eman
Obeidat, Basil
Obeidat, Rawan
Rawashdeh, Hasan
Yaseen, Hashem
author_sort Sindiani, Amer Mahmoud
collection PubMed
description OBJECTIVE: To study factors associated with the success of single dose methotrexate (MTX) treatment in women with ectopic pregnancy. METHODS: This is a retrospective study of women (n=110) with ectopic pregnancy and treated with single dose of MTX. The clinical presentations, transvaginal sonography (TVS) findings, pretreatment beta-human chorionic gonadotropin (β-HCG), and progesterone values were compared between the treatment success (Group S) and treatment failure (Group F) groups. RESULTS: The overall success rate of treatment with single dose of MTX was 75.45%. The majority of patients in both groups presented with pain and bleeding (~55%), and bleeding only was the presenting symptom in about 20% of patients. Only 3 patients (3.61%) in Group S required a repeat dose of MTX. In contrast, 51.8% of the Group F patients required a repeat dose. The mean pretreatment β-HCG level was 2.3 times higher in Group F than in Group S (1734±1684 vs 4036±2940 IU/L). The data showed a β-HCG level of 3924IU/L as a suitable cut-off value with 76.19% sensitivity and 62.5% specificity to predict MTX treatment success. History of ectopic pregnancy had no relation with success/treatment failure or a repeat dose. None of the TVS findings were related to the outcome of the treatment, whereas pretreatment HCG level was a significant predictor. CONCLUSION: The single dose MTX treatment was successful in 75.45% (83/110) of cases, with 3.61% (3/83) requiring a repeat dose of the drug. Pretreatment β-HCG level is a significant predictor of the treatment outcome.
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spelling pubmed-77649642020-12-28 The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center Sindiani, Amer Mahmoud Alshdaifat, Eman Obeidat, Basil Obeidat, Rawan Rawashdeh, Hasan Yaseen, Hashem Int J Womens Health Original Research OBJECTIVE: To study factors associated with the success of single dose methotrexate (MTX) treatment in women with ectopic pregnancy. METHODS: This is a retrospective study of women (n=110) with ectopic pregnancy and treated with single dose of MTX. The clinical presentations, transvaginal sonography (TVS) findings, pretreatment beta-human chorionic gonadotropin (β-HCG), and progesterone values were compared between the treatment success (Group S) and treatment failure (Group F) groups. RESULTS: The overall success rate of treatment with single dose of MTX was 75.45%. The majority of patients in both groups presented with pain and bleeding (~55%), and bleeding only was the presenting symptom in about 20% of patients. Only 3 patients (3.61%) in Group S required a repeat dose of MTX. In contrast, 51.8% of the Group F patients required a repeat dose. The mean pretreatment β-HCG level was 2.3 times higher in Group F than in Group S (1734±1684 vs 4036±2940 IU/L). The data showed a β-HCG level of 3924IU/L as a suitable cut-off value with 76.19% sensitivity and 62.5% specificity to predict MTX treatment success. History of ectopic pregnancy had no relation with success/treatment failure or a repeat dose. None of the TVS findings were related to the outcome of the treatment, whereas pretreatment HCG level was a significant predictor. CONCLUSION: The single dose MTX treatment was successful in 75.45% (83/110) of cases, with 3.61% (3/83) requiring a repeat dose of the drug. Pretreatment β-HCG level is a significant predictor of the treatment outcome. Dove 2020-12-22 /pmc/articles/PMC7764964/ /pubmed/33376413 http://dx.doi.org/10.2147/IJWH.S279426 Text en © 2020 Sindiani et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Sindiani, Amer Mahmoud
Alshdaifat, Eman
Obeidat, Basil
Obeidat, Rawan
Rawashdeh, Hasan
Yaseen, Hashem
The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center
title The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center
title_full The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center
title_fullStr The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center
title_full_unstemmed The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center
title_short The Use of Single Dose Methotrexate in the Management of Ectopic Pregnancy and Pregnancy of Unknown Location: 10 Years’ Experience in a Tertiary Center
title_sort use of single dose methotrexate in the management of ectopic pregnancy and pregnancy of unknown location: 10 years’ experience in a tertiary center
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764964/
https://www.ncbi.nlm.nih.gov/pubmed/33376413
http://dx.doi.org/10.2147/IJWH.S279426
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