Predictors of treatment failure for ectopic pregnancy treated with single-dose methotrexate

2000 ◽  
Vol 74 (5) ◽  
pp. 877-880 ◽  
Author(s):  
Afaf Tawfiq ◽  
Abdul-Fattah Agameya ◽  
Paul Claman
Keyword(s):  
Single Dose ◽  
Treatment Failure ◽  
Ectopic Pregnancy ◽  
Dose Methotrexate

scholarly journals Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Feras Sendy ◽  
Eman AlShehri ◽  
Amani AlAjmi ◽  
Elham Bamanie ◽  
Surekha Appani ◽  
...  
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Failure Rate ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Treatment Modalities ◽  
Pregnancy Failure ◽  
Dose Methotrexate ◽  
Mass Size ◽  
Primary Management

Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure.Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate.Results. 225 patients had methotrexate. Most of the patients (151 (67%)) received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225) of the patients. 28% (63/225) were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63) of failure received a second dose of methotrexate, and 37% (23/63) underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound.Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

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

2017 ◽  
Vol 33 (1) ◽  
Author(s):  
Emre Erdem Taş ◽  
Gülin Feykan Feykan Yeğin Akçay ◽  
Ayse Filiz Avsar
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Dose Methotrexate

scholarly journals The Importance of Gestational Sac Size of Ectopic Pregnancy in Response to Single-Dose Methotrexate

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Parichehr Kimiaei ◽  
Zahra Khani ◽  
Azadeh Marefian ◽  
Maryam Gholampour Ghavamabadi ◽  
Maryam Salimnejad
Keyword(s):  
Single Dose ◽  
Confidence Interval ◽  
Ectopic Pregnancy ◽  
Baseline Level ◽  
Surgical Intervention ◽  
Dose Methotrexate ◽  
Causal Pathway ◽  
Gestational Sac ◽  
Logistic Regressions ◽  
Predictor Factors

This retrospective cohort study was designed in a selective group of 185 patients diagnosed with and treated for ectopic pregnancy. Intramuscular administration of a single dose of methotrexate (50 mg/m2) was performed to measure predictors of failure or resistance to treatment necessitating surgical intervention. During the time of treatment with a single dose of MTX, 20 patients (10.8%) failed to response, in which 6 of 20 (30%) indicated side effects to MTX and rupture of the ectopic pregnancy. Remaining cases () showed resistance to the drug; the level of β-hCG did not fall at least 15% during 7 days after treatment and necessitated laparotomy. In backward-step analysis by multiple logistic regressions of various types of predictor factors, size of gestational sac (coefficient = 1.91, OR = 6.78, 95% confidence interval = 3.18–8.22) and baseline level β-hCG (coefficient = 1.60, OR = 5.0, 95% confidence interval = 4.26–6.72) had significant correlation with leading EP patients failing to response to MTX. This study suggests that further investigation for finding relative contraindications of MTX treatment in EP women should be considered on the gestational sac size because other variables are in the causal pathway of this variable.

Sign in / Sign up

Export Citation Format

Share Document