Objective To explore early predictive value of beta human chorionic gonadotropin(β-HCG) in the treatment of ectopic pregnancy treated by methotrexate(MTX).
Methods A total of 197 ectopic pregnancy patients treated with MTX in our hospital were as the research objects, and were divided into two groups according to different treatments: single-dose methotrexate treatment group (n=167), and second-dose methotrexate treatment group (n=30). The clinical data including epidemiological characteristics, mass size of ectopic pregnancy, and the level of β-HCG at 0, 4 and 7 d of treatment were collected and analyzed.
Results The epidemiological characteristics, and mass size of ectopic pregnancy of two groups showed no significant difference(P>0.05). The β-HCG levels at 0, 4, and 7 d, from 0 to 4 d and 4 to 7 d also showed significant difference between the two groups(P < 0.05). The decreased cutoff value of β-HCG from 0 to 4 d was 18% after treatment by MTX(AUC=0.731, P < 0.01) and 15% from 4 to 7 d(AUC=0.869, P < 0.001). After MTX treatment, the proportion of additional treatment of MTX in patients with a decrease≥18% was 77% less than those with a decrease < 18% (95% CI: 0.69~0.85; P < 0.001). The probability of an additional MTX treatment was 70% higher in patients with a β-HCG decrease < 15% from 4 to 7 d than those who had a decrease ≥15% (95% CI: 1.30~2.21, P < 0.001).
Conclusion It is considered to be an evidence to monitor changes of β-HCG levels from 0 to 4 d for early prediction of additional MTX treatment, but further prospective study is needed.
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