Comparing four different methods for the management of ectopic pregnancy: A cross-sectional study

Area of Science:

• Reproductive Medicine
• Gynecology
• Obstetrics

Background:

• Ectopic pregnancy (EP) is a leading cause of first-trimester maternal mortality.
• Timely and appropriate management is crucial for patient outcomes.

Purpose of the Study:

• To compare the effectiveness of different ectopic pregnancy treatment methods.
• To identify optimal management strategies based on clinical characteristics.

Main Methods:

• A cross-sectional study reviewed 365 women diagnosed with EP.
• Receiver operating characteristics (ROC) curves determined cut-off points for ectopic mass size and beta-human chorionic gonadotropin (β-hCG) levels.
• Management strategies included single-dose methotrexate (SD-MTX), double-dose methotrexate, expectant management, and surgery.

Main Results:

• The adnexa was the most common site for EP.
• Surgery was indicated for ectopic masses ≥34.50 mm or initial β-hCG levels ≥6419 mIU/ml.
• SD-MTX demonstrated a higher success rate and shorter hospitalization compared to double-dose methotrexate, with significantly lower β-hCG levels in successful treatments.

Conclusions:

• Surgery is recommended for large ectopic masses or high β-hCG levels.
• SD-MTX is an efficient and safe alternative treatment with a superior success rate and reduced hospital stay compared to double-dose protocols.
• Further large-scale randomized trials are recommended to validate these findings.