The Retrospective Analysis of Factors Determining the Success of Single-Dose Methotrexate Treatment in Ectopic Pregnancy

Abstract

Objective: We aimed to investigate treatment outcomes, treatment failure rates, factors causing failure, and complications of treatment in patients followed up with ectopic pregnancy and receiving methotrexate (MTX) treatment. Materials and methods: All ectopic pregnancies in a tertiary perinatology center who had single dose MTX between January 2015 and January 2021 were retrospectively included in this study. The demographic data of the women (age, gravida, parity, abortus numbers) and delivery [normal and cesarean sectio (C/S)] types were analyzed. The size of the mass, β-hCG level, presence of intra-abdominal free fluid and USG findings were recorded. The effectiveness of the treatment and the need for surgical treatment after MTX treatment were also investigated. Results: Overall, 93 ectopic pregnancies who had single dose MTX treatment were included in this study. The mean age was 30.4 years (SD ± 5.2). Previous ectopic pregnancy rate was 9.9% and 13.6% had free fluid in the abdomen. More than one third (35.8%) had undergone previous surgery and 8.6% had chronic disease. The median β-hCG level was 1763 mIU/ml (minimum 129 – maximum 67854, IQR 1010 - 2723 mIU/ml). The mean size of the mass was 9.3 mm (SD±6.1). A single dose of MTX treatment was found to be effective in 51.9%. β-hCG levels at the time of admission, mass size, patients age and pregnancy week were not effective on the success of single-dose MTX treatment. Conclusion: Single dose MTX therapy is used effectively and safely in the first treatment of ectopic pregnancy.