Beta-Human Chorionic Gonadotropin and Uterine Artery Doppler Measurements for the Prediction of Success of Single Dose Methotrexate Treatment in Tubal Ectopic Pregnancies

Kılıç Çiğdem
Mehmet Metin Altay
Tuğba Kınay
Metin Kaplan
Serap Fırtına Tuncer
Enis Özkaya
Ahmet Okyar Erol
Orhan Gelişen
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Objectives: To evaluate the impact of the uterine artery Doppler values and the change of β-Human chorionic gonadotropin (β-HCG) levels from day 0 to day 4 for prediction of the success of single dose methotrexate treatment in tubal pregnancy cases.
Study Design: 50 patients with tubal pregnancy were included the prospective study. The location and size of ectopic pregnancy, bilateral uterine artery pulsed color doppler imaging was examined by ultrasonography and serum β-HCG levels were measured on day 0, 4, 7 of treatment. Success was defined as decrease of β-HCG level <10 mIU/mL with single dose methotrexate treatment. Multiple dose methotrexate treatment and surgical treatment were considered as treatment failure.
Results: 32 patients (64%) treated with single dose methotrexate, 14 patients (28%) treated with multiple dose methotrexate, and 4 patients (8%) treated with surgery. In the group with β-HCG level decrease > 15.04% on day 4, single-dose methotrexate therapy were 3.82 times more successful than the group without > 15.04% β-HCG decrease. However, no significant alteration of uterine artery Doppler measurements was determined on the same days.
Conclusion: Reduction rate in the β-HCG level on day 4 of treatment can be used in determination the success of single-dose methotrexate therapy.


β-Human chorionic gonadotropin, Ectopic pregnancy, Methotrexate, Single dose, Uterine artery Doppler


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