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Published on: November 8, 2015
An alternative monitoring protocol for single-dose methotrexate therapy in ectopic pregnancy
Andrea Ries Thurman1, Melani Cornelius, Jeffrey E Korte
1Department of Obstetrics and Gynecology, Eastern Virginia Medical School, CONRAD Clinical Research Center, 601 Colley Ave., Norfolk, VA 23507, USA. thurmaar@evms.edu
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 (beta-hCG) level decreased by > or = 50%, compared with the day-of-treatment (DOT) beta-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 beta-hCG was <2000 mIU/mL and was 100% sensitive and 37.9% specific in women whose DOT beta-hCG was > or = 2000 mIU/mL.
Conclusion:
This model is an alternative to the traditional MTX monitoring regimen.
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