title: An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  This model is an alternative to the traditional MTX monitoring regimen.
authors: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, CONRAD Clinical Research Center, 601 Colley Ave., Norfolk, VA 23507, USA. thurmaar@evms.edu
authors: Andrea Ries
authors: AR
authors: Thurman
authors: Melani
authors: M
authors: Cornelius
authors: Jeffrey E
authors: JE
authors: Korte
authors: Donald L
authors: DL
authors: Fylstra
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000188:drug therapy*
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate