title: ß-hCG and prediction of therapeutic success in ectopic pregnancies treated with methotrexate, results from a prospective observational study.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of different beta-human chorionic gonadotrophin (ß-hCG) levels measurement, for predicting success of medical treatment in cases diagnosed as tubal ectopic pregnancy (TEP).
  
  
  METHODS
  Five-year prospective observational study.
  
  
  METHODS
  Prenatal Diagnosis Unit, Vall d'Hebron University Hospital - Barcelona.
  
  
  METHODS
  TEP cases fulfilling criteria for medical treatment with Methotrexate.
  
  
  METHODS
  ß-hCG levels were measured on d 0, 4 and 7 of treatment. Results were compared by non-parametrical tests. A ROC curve was plotted to define cut-off points. Diagnostic accuracy of the different measurements was evaluated.
  
  
  METHODS
  Failure of treatment defined as need for surgical treatment or persistence of high ß-HCG levels despite treatment.
  
  
  RESULTS
  126 women were diagnosed as TEP, eligible for medical treatment. There were no differences in parity, age, previous TEP, or adnexal mass size. Success rate was 88%. ß-HCG decreased significantly more, between days 0-7 and 4-7, in the successful cases. LR for success prediction was 6.2 and 7.8 for ß-HCG levels at days 4 and 7 respectively, 4.02 and 2.47 for decrement between days 0-7 (25%) and 4-7 (20%), respectively.
  
  
  CONCLUSIONS
  ß-hCG cutoff values have a potential for predicting a successful medical treatment of TEP.
authors.affiliation: Maternal Fetal Medicine, Hospital Universitari Vall d'Hebron , Barcelona , Spain .
authors.forename: Esteban Mauricio
authors.initials: EM
authors.lastname: Orozco
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Sánchez-Durán
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Bello-Muñoz
authors.forename: Juan
authors.initials: J
authors.lastname: Sagalá
authors.forename: Elena
authors.initials: E
authors.lastname: Carreras
authors.forename: Lluis Cabero
authors.initials: LC
authors.lastname: Roura
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D055815:Young Adult; D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005500:Follow-Up Studies; D008727:Methotrexate / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011271:Pregnancy, Ectopic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate
keywords: Beta-human chorionic gonadotrophin; ectopic pregnancy; methotrexate