Document Detail


Cutoff value of human chorionic gonadotropin in relation to the number of methotrexate cycles in the successful treatment of ectopic pregnancy.
MedLine Citation:
PMID:  18851850     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assign cutoff values for human chorionic gonadotropin (beta-hCG) in pretreatment and after one methotrexate (MTX) cycle and determine its correspondence to the number of MTX cycles in successfully treated ectopic pregnancy. DESIGN: Retrospective study. SETTING: Polish university hospital. PATIENT(S): 68 women with ectopic pregnancies who qualified for medical treatment. INTERVENTION(S): A single-dose of MTX (50 mg/m(2)) repeated every 7 days, plus laparoscopy in cases of tubal rupture or increased (>or=50% over 1 week) beta-hCG concentration. MAIN OUTCOME MEASURE(S): Resolution of serum beta-hCG without the necessity of laparoscopy. RESULT(S): Success rate was 78% (53 of 64 women). The medians of pretreatment beta-hCG levels in the groups treated successfully and unsuccessfully (943 vs. 3085 mIU/mL) and after the first dose of MTX (564 vs. 4049 mIU/mL) were statistically significantly different. The decrease in beta-hCG level after one MTX dose differed statistically significantly only in successfully treated women. The receiver operating characteristic (ROC) curve cutoff value in the success group indicated an initial beta-hCG level of 1790 and 1218 mIU/mL after one MTX cycle. The median of beta-hCG titer was not statistically different in patients requiring one or more treatment cycles. CONCLUSION(S): When the beta-hCG level is >1790 mIU/mL, the MTX treatment of ectopic pregnancy is at risk of failure. However, the initial beta-hCG titer is not a predictor of the number of MTX cycles that can guarantee a successful outcome.
Authors:
Ewa Nowak-Markwitz; Marcin Michalak; Mikołaj Olejnik; Marek Spaczynski
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-10-11
Journal Detail:
Title:  Fertility and sterility     Volume:  92     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1203-7     Citation Subset:  IM    
Affiliation:
Department of Gynecologic Oncology, Division of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Science, Poznan, Poland. ewamarkwitz@poczta.fm
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage
Adult
Chorionic Gonadotropin / analysis,  blood*,  standards
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Humans
Methotrexate / administration & dosage*
Pregnancy
Pregnancy, Ectopic / blood,  diagnosis,  drug therapy*
Prognosis
Reference Values
Retrospective Studies
Sensitivity and Specificity
Treatment Failure
Treatment Outcome
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Chorionic Gonadotropin; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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