Are early human chorionic gonadotropin levels after methotrexate therapy a predictor of response in ectopic pregnancy?
OBJECTIVE
The purpose of this study was to evaluate beta-human chorionic gonadotropin (beta-hCG) levels between days 0 and 4 as a predictor of methotrexate therapy success for ectopic pregnancy.


METHODS
We conducted a retrospective study that evaluated posttreatment beta-hCG levels of 30 patients with ectopic pregnancy who had been treated with single-dose methotrexate therapy.


RESULTS
beta-hCG levels decreased between days 0 and 4 in 40.0% of cases, and 100% of these cases had treatment success. beta-hCG levels increased in 60.0% of cases, and 61.8% of these cases had treatment success. In patients with increasing beta-hCG levels on day 4, we calculated the beta-hCG "difference variable" (beta-hCG level at day 4 minus day 0). The median beta-hCG difference variable between cases of treatment success and failure were statistically significant (P = .035).


CONCLUSIONS
beta-hCG level changes between days 0 and 4 after methotrexate therapy have clinical significance and predictive value. Decreasing beta-hCG levels is highly predictive of treatment success. The beta-hCG difference variable is a reliable predictor of success in cases with rising beta-hCG levels after methotrexate therapy.
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, FL, USA.
Quyen
Q
Nguyen
Martha
M
Kapitz
Katheryne
K
Downes
Celso
C
Silva
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000028:Abortion, Induced / Q000379:methods; D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D018579:Patient Selection; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000188:drug therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate