An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy

Objective

We sought to determine the sensitivity and specificity of alternative monitoring regimens in predicting the need for a second methotrexate (MTX) dose in women undergoing medical therapy for ectopic pregnancy.

Study Design

We reviewed 187 women who received MTX for ectopic pregnancy.

Results

We defined MTX treatment success as a clinically stable patient whose day-7 beta human chorionic gonadotropin (β-hCG) level decreased by ≥50%, compared with the day-of-treatment (DOT) β-hCG. In comparison to the standard MTX monitoring protocol, this model was 100% sensitive and 57.4% specific in predicting the need for a second MTX dose in women whose DOT β-hCG was <2000 mIU/mL and was 100% sensitive and 37.9% specific in women whose DOT β-hCG was ≥2000 mIU/mL.

Conclusion

This model is an alternative to the traditional MTX monitoring regimen.

Key words: ectopic pregnancy, methotrexate, therapy monitoring