Evaluation of the relationship between endometrial thickness and failure of single-dose methotrexate in ectopic pregnancy.
OBJECTIVE
To test the hypothesis that endometrial stripe thicker than 12 mm increases treatment failure of single-dose methotrexate for the management of ectopic pregnancy.


METHODS
Seventy-three patients with ectopic pregnancy and measured pretreatment endometrial stripe were divided into two groups based on the endometrial stripe thickness (> 12 mm or < or = 12 mm). All patients were candidates for single-dose methotrexate treatment. Variables analyzed between the two groups were endometrial stripe thickness, initial beta human chorionic gonadotropin level (hCG), size of the ectopic mass, presence of fetal heart tones, previous ectopic pregnancy, and clinical outcomes.


RESULTS
Sixty patients had endometrial stripe thickness < or = 12 mm and 13 patients > 12 mm. The two groups were similar in initial hCG, size of ectopic mass, presence of fetal heart tones and rate of previous ectopic pregnancy. The failure rate was significantly higher in the group with endometrial stripe > 12 mm compared to the group < or = 12 mm (n=7, 53% vs. n=3, 5%, P<0.01). The endometrial stripe was significantly thicker in the group with endometrial stripe thickness > 12 mm compared to the group < or = 12 mm (mean +/- SD, 17.64+/-5.82 mm vs. 7.69+/-2.82 mm, P<0.01).


CONCLUSIONS
Endometrial stripe thicker than 12 mm increases the risk for treatment failure with single-dose methotrexate.
Department of Obstetrics and Gynecology, Jackson Memorial Hospital, University of Miami School of Medicine, P.O. Box 016960, Miami, FL 33010, USA. ptakacs@med.miami.edu
Peter
P
Takacs
Nahida
N
Chakhtoura
Timothy
T
De Santis
Usha
U
Verma
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D015331:Cohort Studies; D004717:Endometrium / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D017211:Treatment Failure; D014463:Ultrasonography
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate