Do the change in β-hCG values between the 0th and 4th days in tubal ectopic pregnancy treatment with a single-dose methotrexate (MTX) protocol predict the need for a second dose of MTX?

Reis, Yildiz Akdas; AKAY ACEMOĞLU, Arife; Ozkan, Merve; Firatligil, Fahri Burcin; Dereli, Murat Levent; Kinay, Tugba; Erkaya, Salim

doi:10.1007/s00404-023-07116-3

Do the change in β-hCG values between the 0th and 4th days in tubal ectopic pregnancy treatment with a single-dose methotrexate (MTX) protocol predict the need for a second dose of MTX?

Yazarlar (7)

Yildiz Akdas Reis Etlik Zubeyde Hanim Gynecology Education & Research Hospital, Türkiye

Dr. Öğr. Üyesi Arife AKAY ACEMOĞLU Etlik Zubeyde Hanim Gynecology Education & Research Hospital, Türkiye

Merve Ozkan Etlik Zubeyde Hanim Gynecology Education & Research Hospital, Türkiye

Fahri Burcin Firatligil Etlik Zubeyde Hanim Gynecology Education & Research Hospital, Türkiye

Murat Levent Dereli Etlik Zubeyde Hanim Gynecology Education & Research Hospital, Türkiye

Tugba Kinay Etlik Zubeyde Hanim Gynecology Education & Research Hospital, Türkiye

Salim Erkaya Etlik Zubeyde Hanim Gynecology Education & Research Hospital, Türkiye

Makale Türü	Özgün Makale (SSCI, AHCI, SCI, SCI-Exp dergilerinde yayınlanan tam makale)
Dergi Adı	Archives of Gynecology and Obstetrics (Q2)
Dergi ISSN	0932-0067 Dergi Bilgileri (2023)
Dergi Tarandığı Indeksler	SCI
Makale Dili	Türkçe	Basım Tarihi	07-2023
Kabul Tarihi	20-06-2023	Yayınlanma Tarihi	26-07-2023
Cilt / Sayı / Sayfa	309 / 6 / 2585–2590	DOI	10.1007/s00404-023-07116-3
Makale Linki	https://www.researchsquare.com/article/rs-2821697/latest.pdf
UAK Araştırma Alanları	Kadın Hastalıkları ve Doğum

Özet

Abstract
Aim: The single-dose methotrexate (MTX) regimen is effective and minimizes side effects but an additional 2nd dose is needed in case of failure in an ectopic pregnancy (EP). We aimed to predict the additional MTX dose by evaluating the change in β-hCG values between day 0 and day 4 in EPs with administered single-dose MTX regimen.
Method: A total of 454 tubal EPs between 2013 and 2019 were evaluated retrospectively. Cases cured with a single dose of MTX without an additional dose were accepted as the control group, and cases under a single-dose regimen were cured by applying a second dose of MTX on the 7th day were accepted as the study group. Obstetric and demographic characteristics and the change in β-hCG values compared in both groups.
Results: Age, body mass index (BMI), gravida, smoking, abdominal surgery, presence of IUDs, initial β-hCG levels (0th day), and EP size were similar in both groups, but the presence of previous EP history was significantly higher in the study group. The change of β-hCG from days 0 and 4 determined that a 20% increase predicts the need for a 2nd dose of MTX with 72.4% sensitivity, and 87.8% negative predictive value (NPV).
Conclusion: The single-dose MTX protocol is successful in 83.3% of convenient cases (as the control group), but, an increase of 20% in β-hCG between days 0 and 4 predicts the patients that need to be administered 2nd dose MTX, and thus, a double-dose MTX protocol will be achieved early.

Anahtar Kelimeler

"Ectopic pregnancy" | "Methotrexate" | "B-hcG" | "Single dose" | "Second dose"

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Atıf Sayıları
Web of Science	1
Scopus	1

Do the change in β-hCG values between the 0th and 4th days in tubal ectopic pregnancy treatment with a single-dose methotrexate (MTX) protocol predict the need for a second dose of MTX?

Dergi Adı	ARCHIVES OF GYNECOLOGY AND OBSTETRICS
Kısa Adı	ARCH GYNECOL OBSTET
Yayıncı	SPRINGER HEIDELBERG
Açık Erişim	Evet
ISSN	0932-0067
E-ISSN	1432-0711
Wos Quartile	Q2
Scopus Quartile	Q2
Tarandığı Indeksler	SCIE , Scopus
WoS Kategoriler	OBSTETRICS & GYNECOLOGY
Scopus Kategoriler	MEDICINE (MISCELLANEOUS) \| OBSTETRICS AND GYNECOLOGY