Abstract
Adherence to the Single-Dose Methotrexate Protocol for the Management of Ectopic Pregnancy in an Inner City Population: A retrospective cohort and protocol analysis
Highlights
Methotrexate (MTX) is a common medical treatment of unruptured ectopic pregnancy (EP)
Neither success of treatment nor morbidity was adversely affected by non-adherence to current standard protocol
Adherence to this protocol in inner city populations is poor; less than 20% of patients adhere to the follow-up protocol and greater than 50% are lost to follow-up [2]
Summary
Methotrexate (MTX) is a common medical treatment of unruptured ectopic pregnancy (EP). The standard singledose treatment regimen administers a weight -based MTX injection on day 1 and follows human chorionic gonadotropin (hCG) levels on days 1, 4 and 7. Successful treatment is defined as a ≥15% decrease between day 1 and day 4 or day 7 [1] Adherence to this protocol in inner city populations is poor; less than 20% of patients adhere to the follow-up protocol and greater than 50% are lost to follow-up [2]. Poor adherence to follow-up after MTX raises concerns regarding the utility and safety of the current standard of care protocol. Several studies have validated alternative protocols which define treatment success as a decrease in hCG of ≥ 20% between days 1 and 4, or ≥50% days 1 and 7 [3]
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