title: Comparison of single-dose and two-dose methotrexate protocols for the treatment of unruptured ectopic pregnancy.
abstract: Summary The purpose of this study was to compare the safety and success rates of single- and two-dose methotrexate (MTX) protocols for the treatment of unruptured tubal ectopic pregnancy. This retrospective study included 87 patients with ectopic pregnancy who were treated with MTX therapy (single-dose protocol: 46 patients; two-dose protocol: 41 patients). Both protocol groups were compared with regard to success rates, β-hCG and progesterone levels, the presence of cardiac activity, a history of previous ectopic pregnancy, ectopic mass size, gestational age, adverse events, and number of repeat MTX doses. Success rates between the single-dose and two-dose methotrexate therapy groups were comparable (87% vs 90.2%; OR 0.7, 95% CI 0.18-2.75; p = 0.74). No significant differences were found between the groups in factors influencing MTX treatment success rate, including the mean β-hCG level, mean progesterone level, the presence of a positive cardiac activity, mean ectopic mass size, mean endometrial thickness, and the presence of a yolk sac. There were also no significant between-group difference were found in the percentage of women who needed a repeat dose of MTX (17.3% vs 7.3%; OR 0.3, 95% CI 0.09-1.52; p = 0.20) and in the percentage of adverse events (45.7% vs 58.7%; OR 1.6, 95% CI 0.71-3.93; p = 0.28). In conclusion, medical treatment with single-dose or with two-dose systemic MTX seem to be equal therapeutic options for patients with unruptured ectopic pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Mardin Women and Children Hospital Mardin, Istanbul, Turkey. maidenkemal@yahoo.com
authors.forename: K
authors.initials: K
authors.lastname: Gungorduk
authors.forename: O
authors.initials: O
authors.lastname: Asicioglu
authors.forename: G
authors.initials: G
authors.lastname: Yildirim
authors.forename: O Celikkol
authors.initials: OC
authors.lastname: Gungorduk
authors.forename: B
authors.initials: B
authors.lastname: Besimoglu
authors.forename: C
authors.initials: C
authors.lastname: Ark
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008727:Methotrexate