Journal of Krishna Institute of Medical Sciences University (Oct 2020)
The Importance of 24-hour β-hCG Change Before Treatment and β-hCG Change between 1-4 days in Predicting the Success of a Single Dose Methotrexate Treatment
Abstract
Background: Ectopic pregnancy treatment with a single dose of methotrexate, causes patients to stay in hospital for a long time, increases the cost of treatment, decreases the compliance of the patient, and leads to loss of work force. Aim and Objectives: The aim of this study was to predict the success of single dose Methotrexate (MTX) treatment in ectopic pregnancy at an early period. Material and Methods: Between 1st January 2018 –31st December 2019 at the University of Health Sciences, Tepecik Education and Research Hospital, ectopic pregnancy patients who were treated with single dose MTX (50 mg/m2) were included in the study. Clinical and laboratory parameters were evaluated. Results: The data of 100 patients that met our criteria were analyzed. Patients enrolled in the study, were divided into 2 groups. Group 1 MTX treatment failed group (n = 50) and Group 2 MTX treatment successful group (n = 50). Pre-treatment of beta-human Chorionic Gonadotrophin (β-hCG) values of the patients was of the MTX treatment failed group to be higher than those of the MTX treatment successful group (p < 0.001). Although the pretreatment β-hCG change within 24 hour was higher in the MTX treatment failed group, the difference was not significant in the groups. The β-hCG change between 1st and 4th days, the average β-hCG value in the treatment failed group tended to increase, whereas in the group where the treatment successful, it tended to decrease and the results were significant (p = 0.004). Conclusion: Ectopic pregnancy is a serious obstetric complication that causes maternal morbidity and mortality. Therefore, early diagnosis and treatment is important. Especially, a single dose MTX treatment is an effective and safe option in the treatment of ectopic pregnancy. In this study, pre-treatment β-hCG values were significantly higher in the MTX failed group. The β-hCG values 24 hour before the start of the treatment and the β-hCG change at the beginning of the treatment were examined, and no difference was found between the groups in terms of predicting success in a single dose of MTX. On the other hand, the β-hCG change between the 1st and 4th days was an early predictor of the medical treatment success.
