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Predicting success of methotrexate treatment by pretreatment HCG level and 24‐hour HCG increment
Author(s) -
Levin Gabriel,
Saleh Narjes A.,
HajYahya Rani,
Matan Liat S.,
Avi Benshushan
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12395
Subject(s) - methotrexate , medicine , human chorionic gonadotropin , ectopic pregnancy , logistic regression , cutoff , receiver operating characteristic , gonadotropin , pregnancy , gynecology , obstetrics , urology , hormone , physics , quantum mechanics , biology , genetics
Objective To evaluate β‐human chorionic gonadotropin (β‐ HCG ) level and its 24‐hour increment as predictors of successful methotrexate treatment for ectopic pregnancy. Methods Data were retrospectively reviewed from women with ectopic pregnancy who were treated by single‐dose methotrexate (50 mg/m 2 ) at a university hospital in Jerusalem, Israel, between January 1, 2000, and June 30, 2015. Serum β‐ HCG before treatment and its percentage increment in the 24 hours before treatment were compared between treatment success and failure groups. Results Sixty‐nine women were included in the study. Single‐dose methotrexate treatment was successful for 44 (63.8%) women. Both mean β‐ HCG level and its 24‐hour increment were lower for women with successful treatment than for those with failed treatment (respectively, 1224 IU \L vs 2362 IU \L, P =0.018; and 13.5% vs 29.6%, P =0.009). Receiver operator characteristic curve analysis yielded cutoff values of 1600 IU \L and 14% increment with a positive predictive value of 75% and 82%, respectively, for treatment success. β‐ HCG level and its 24‐hour increment were independent predictors of treatment outcome by logistic regression (both P <0.01). Conclusions A β‐ HCG increment of less than 14% in the 24 hours before single‐dose methotrexate and serum β‐ HCG of less than 1600 IU \L were found to be good predictors of treatment success.