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[Evolution of beta-hCG titers after systemic treatment of unruptured ectopic pregnancy]
J Elito Júnior1, M Uchiyama, L Camano
1Disciplina de Obstetrícia, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo.
Objective:
The follow-up of this treatment is done by monitorization of beta-hCG titers. The objective of this study is to evaluate the beta-hCG titers after treatment with MTX.
Methods:
Twenty four women were included in the study. The inclusion criteria were: ectopic pregnancy < or = 4.5 cm, beta-hCG < or = 15.000 mIU/mL, desire of future pregnancy and a written permission to participate in the study. All patients were treated with a single dose of methotrexate (50 mg/m2 IM). Patients were monitored with beta-hCG titers on days 1, 4 and 7 after the MTX injection, and then weekly until the beta-hCG was less than 25 mIU/mL.
Results:
The variation of the titers of beta-hCG between day 1 and day 4 after MTX was the following: increase 50.0%, decrease 33.3% and in levels less than 25 mUI/mL in 16.7% of the cases. The variation of the titers of beta-hCG between day 4 and day 7 after MTX was the following: decline > or = 15% in 85.7% of the cases, and decline < 15% in 14.3%. There was the necessity of a second dose of MTX in only two cases (8.4%), since the levels of beta-hCG declined less than 15%, in this period.
Conclusion:
The titers of beta-hCG increase in 50.0% of the cases, so it is a frequent event. The understanding of this evolution of beta-hCG titers avoids surgery in the first week of the treatment.
