Prediction of Single Dose Methotrexate Success in Ectopic Pregnancy Treatment

Ectopic pregnancy is the implantation of a blastocyst somewhere other than the endometrial cavity (1). It is one of the most important causes of mortality and morbidity in the first trimester (2). The incidence in all pregnancies varies between 0.5 and 2% (1). The incidence of ectopic pregnancy has increased in recent years due to the increase in the frequency of previous pelvic infections, increased use of intrauterine devices, increased incidence of pelvic inflammatory disease, and increased pregnancy assisted reproductive techniques (3). Early diagnosis and treatment of ectopic pregnancies can be made thanks to the fact that beta human chorionic gonodotropin (β-hCG) values can be routinely examined and transvaginal ultrasonography becomes widespread (4). Medical treatment, surgical treatment or wait and see method are the treatment options. Patients can benefit from medical treatment when the diagnosis can be made while the patients are hemodynamically stable and before rupture (5,6). Medical treatment has many advantages over other treatments; these include less tubal damage, lower cost and preservation of fertility. Single dose methotrexate treatment is an effective and safe medical treatment and success rates vary between 64% and 94% (7). Methotrexate dose may be repeated or surgery may be performed in patients who fail single dose treatment (8-11). In this study, we aimed to compare successful and unsuccessful patients who underwent single-dose methotrexate treatment for ectopic pregnancy in our hospital and to determine the factors affecting success.