TY - JOUR
T1 - Efficacy of methotrexate treatment in extrauterine pregnancies defined by stable or increasing human chorionic gonadotropin concentrations
AU - Gamzu, Ronni
AU - Almog, Benny
AU - Levin, Yishai
AU - Avni, Amiram
AU - Jaffa, Ariel
AU - Lessing, Joseph B.
AU - Baram, Amiram
PY - 2002
Y1 - 2002
N2 - Objective: To evaluate the efficacy of methotrexate treatment in selected cases of extrauterine pregnancy (EUP) defined by stable or increasing hCG concentration. Design: Prospective cohort study. Setting: Gynecology department of the Lis Maternity Hospital. Patient(s): Fifty women with EUP diagnosed whenever an intrauterine gestational sac was not seen on transvaginal ultrasonography. Intervention(s): Women received IM methotrexate at a dose of 50 mg/m2 of body surface area. Failure of hCG levels to fall by ≥15% during any successive week resulted in repeated administration of methotrexate. Surgical intervention was performed for presumed tubal rupture. Main Outcome Measure(s): Serial hCG measurement was performed weekly until hCG concentration reached 15 mIU/mL. Success was defined as the achievement of hCG concentration of 25 mIU/mL without surgical intervention. Result(s): Forty-four women (88%) were successfully treated. The mean time from first methotrexate injection to success was 34 ± 2.4 days. Women treated successfully and unsuccessfully differed significantly only with regard to serum hCG levels of 1,876 ± 243 and 3,489 ± 376 mIU/mL, respectively. When the initial hCG levels were lower or higher than 2,000 IU/L, the success rate was 97% and 74%, respectively (significant by Fisher's exact test). Conclusion(s): When methotrexate treatment is administrated in a selected group of EUP defined by stable or increasing hCG, it may fail more frequently (26%) when initial hCG levels are >2,000 mIU/mL.
AB - Objective: To evaluate the efficacy of methotrexate treatment in selected cases of extrauterine pregnancy (EUP) defined by stable or increasing hCG concentration. Design: Prospective cohort study. Setting: Gynecology department of the Lis Maternity Hospital. Patient(s): Fifty women with EUP diagnosed whenever an intrauterine gestational sac was not seen on transvaginal ultrasonography. Intervention(s): Women received IM methotrexate at a dose of 50 mg/m2 of body surface area. Failure of hCG levels to fall by ≥15% during any successive week resulted in repeated administration of methotrexate. Surgical intervention was performed for presumed tubal rupture. Main Outcome Measure(s): Serial hCG measurement was performed weekly until hCG concentration reached 15 mIU/mL. Success was defined as the achievement of hCG concentration of 25 mIU/mL without surgical intervention. Result(s): Forty-four women (88%) were successfully treated. The mean time from first methotrexate injection to success was 34 ± 2.4 days. Women treated successfully and unsuccessfully differed significantly only with regard to serum hCG levels of 1,876 ± 243 and 3,489 ± 376 mIU/mL, respectively. When the initial hCG levels were lower or higher than 2,000 IU/L, the success rate was 97% and 74%, respectively (significant by Fisher's exact test). Conclusion(s): When methotrexate treatment is administrated in a selected group of EUP defined by stable or increasing hCG, it may fail more frequently (26%) when initial hCG levels are >2,000 mIU/mL.
KW - Ectopic pregnancy
KW - Methotrexate
UR - http://www.scopus.com/inward/record.url?scp=0036009810&partnerID=8YFLogxK
U2 - 10.1016/S0015-0282(01)03256-3
DO - 10.1016/S0015-0282(01)03256-3
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AN - SCOPUS:0036009810
SN - 0015-0282
VL - 77
SP - 761
EP - 765
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 4
ER -