An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy
Received 10 May 2009; received in revised form 4 July 2009; accepted 24 September 2009. published online 04 December 2009.
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.
aDepartment of Obstetrics and Gynecology, Eastern Virginia Medical School, CONRAD Clinical Research Center, Norfolk, VA
bDepartment of Obstetrics and Gynecology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX
cDepartment of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC
dDepartment of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
Reprints: Andrea Ries Thurman, MD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, CONRAD Clinical Research Center, 601 Colley Ave., Norfolk, VA 23507
Cite this article as: Thurman AR, Cornelius M, Korte JE, et al. An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy. Am J Obstet Gynecol 2010;202:139.e1-6.
ABSTRACT
An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy