An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy.
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.
Thurman
Andrea Ries
AR
Department of Obstetrics and Gynecology, Eastern Virginia Medical School, CONRAD Clinical Research Center, 601 Colley Ave., Norfolk, VA 23507, USA. thurmaar@evms.edu
Cornelius
Melani
M
Korte
Jeffrey E
JE
Fylstra
Donald L
DL
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*
D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate