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TITLE:

EVALUATION OF SYSTEMIC SINGLE DOSE METHOTREXATE TREATMENT IN PATIENTS PRESENT WITH ECTOPIC PREGNANCY

AUTHORS:

Dr Hina Tariq, Dr Iqra Nisar, Dr Arooj Imtiaz

ABSTRACT:

Objective: To assess the success rate of single dose MTX (Methotrexate) treatment among patients present with EP (Ectopic Pregnancy) and to examine the various factors associated with the treatment. Methodology: This retrograde research work carried out in the Madina Teaching Hospital Faisalabad from March 2015 to December 2020. In this research work, we retrieved the characteristics of demography, clinical condition, findings of ultrasonography, pre-treatment serum β-hCG (β-Human Chorionic Gonadotropin) and levels of progesterone of 50 patients present with ectopic pregnancy. The grouping of the patients carried out in accordance with the success of the Methotrexate treatment. Results: Treatment with single dose Methotrexate was successful in 72.40% (n: 32) patients. There was low average pre-treatment level of β-hCG in the group of responders as compared to the group of failures (2080.0 ± 2322.0 vs 5707.0 ± 3885.0 IU/L, P = 0.0010) and 2678.0 IU/L was suitable cut off for the prediction of success (75.0% sensitivity, 73.80% specificity). Furthermore, the rate of failure was 8.450 times greater in the patients whose values of β-hCG were determined greater than cutoff. The availability of the cardiac activity of fetal adversely influenced the success of the treatment (Odds Ratio= 12.0, P = 0.0040). There was no influence of past history of Ectopic Pregnancy, endometrium’s thickness, value of progesterone and free pelvic fluid on the success of treatment. Conclusion: The rate of success of single-dose Methotrexate in current research work was 72.80%, and we discovered that the rate of failure of treatment of Methotrexate was 8.450 times higher in the patients who were present with initial values of serum β‑hCG above 2678.0 IU/L and twelve times greater in the patients present with the fetal cardiac activity. KEYWORDS: Β-Hcg, Sensitivity, Serum, Success Rate, Endometrium, Cardiac Ectopic Pregnancy, Methotrexate, Pregnancy.

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