An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy

Am J Obstet Gynecol. 2010 Feb;202(2):139.e1-6. doi: 10.1016/j.ajog.2009.09.031. Epub 2009 Dec 3.

Abstract

Objective: We sought to determine the sensitivity and specificity of alternative monitoring regimens in predicting the need for a second methotrexate (MTX) dose in women undergoing medical therapy for ectopic pregnancy.

Study design: We reviewed 187 women who received MTX for ectopic pregnancy.

Results: We defined MTX treatment success as a clinically stable patient whose day-7 beta human chorionic gonadotropin (beta-hCG) level decreased by > or = 50%, compared with the day-of-treatment (DOT) beta-hCG. In comparison to the standard MTX monitoring protocol, this model was 100% sensitive and 57.4% specific in predicting the need for a second MTX dose in women whose DOT beta-hCG was <2000 mIU/mL and was 100% sensitive and 37.9% specific in women whose DOT beta-hCG was > or = 2000 mIU/mL.

Conclusion: This model is an alternative to the traditional MTX monitoring regimen.

MeSH terms

  • Adult
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Female
  • Humans
  • Logistic Models
  • Methotrexate / administration & dosage*
  • Pregnancy
  • Pregnancy, Ectopic / blood
  • Pregnancy, Ectopic / drug therapy*

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • Methotrexate