Analysis of Clinical Effect and Influencing Factors for Conservative Treatment in Ectopic Pregnancy

Abstract

Background: The curative effect of four different kinds of conservative treatment of ectopic pregnancy (EP) and the risk factors affecting the curative effect of conservative treatment of ectopic pregnancy were compared and analyzed. Methods: Retrospective analysis of the clinical data of patients with ectopic pregnancy treated conservatively in our hospital during the last 10 years. We compared and analyzed the clinical efficacy of four regimens: the expectant treatment, methotrexate (MTX), and methotrexate combined with mifepristone. Logistic regression was used to analyze the influencing factors of the curative effect for conservative treatment of ectopic pregnancy. Results: Initial serum of β human chorionic gonadotrophin (β-hCG) for the four groups of patients demonstrated statistically significant differences in β-hCG level and treatment success rate between groups (p < 0.05). When the serum β-hCG level was less than 1000 mIU/mL, the levels in the expected treatment group and mifepristone group were statistically significant (p = 0.002). There were no statistically significant differences in the treatment success rates between the four groups (p = 0.263). When the serum β-hCG level was ≥1000 mIU/mL, the treatment success rate of MTX combined with mifepristone group (9/15, 60%) was significantly higher than that of the other treatment groups (10/34, 29.4%). This difference was statistically significant (p = 0.045). When logistic regression analysis was performed, the initial serum β-hCG level (odds ratio (OR) = 0.999, 95% confidence interval (95% CI) 0.999–1) and abdominal pain score (OR = 0.4, 95% CI 0.267–0.6) were independent risk factors affecting the success of conservative treatment of ectopic pregnancy. Conclusions: Initial serum β-hCG level and abdominal pain score are the main risk factors affecting the success of conservative treatment of EP. When the serum β-hCG level was less than 1000 mIU/mL, there was no significant difference between the four conservative treatment regimens. When the serum β-hCG level was ≥1000 mIU/mL, the cure rate of MTX combined with mifepristone had obvious advantages over other regimens.

Keywords

• ectopic pregnancy
• conservative treatment
• methotrexate
• mifepristone