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Predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate
Author(s) -
Elito J.,
Reichmann A.P.,
Uchiyama M.N.,
Camano L.
Publication year - 1999
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 - 10.1016/s0020-7292(99)00114-9
Subject(s) - medicine , methotrexate , ectopic pregnancy , obstetrics and gynaecology , pregnancy , obstetrics , gestational sac , surgery , genetics , biology
Objective: To evaluate the efficacy of a predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate in order to select the best cases for the medical treatment. Method: Our study included 40 patients. The inclusion criteria were: hemodynamic stability; adnexal mass ≤3.5 cm; desire of future pregnancy; and a written permission to participate in the study. All patients were treated with a single dose of methotrexate (50 mg/m 2 i.m.). A predictive score was elaborated based on four parameters: initial levels of beta‐hCG, aspects of the image at ultrasound (hematosalpinx, tubal ring or live embryo), size of the mass, vascular flow of the color Doppler. Each parameter received a grade from 0 to 2. Grade 0 represented an unfavorable situation, grade 1 a borderline situation and grade 2 a favorable situation. Results: The success rate with a single dose of methotrexate was 75% (30/40). In the present study the cut off grade was 5, because the majority of patients with grade ≥5 were treated successfully (29/30 — 97%), while those with grade <5 failed. Conclusion: The predictive score helps us to indicate the best cases for the medical treatment. Therefore, we do not advise it when the grade is <5. However, we can predict a good evolution of the treatment when the grade is ≥5.