Predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate.

Abstract

OBJECTIVE:

To evaluate the efficacy of a predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate in order to select the best cases for the medical treatment.

METHOD:

Our study included 40 patients. The inclusion criteria were: hemodynamic stability; adnexal mass < or = 3.5 cm; 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 i.m.). A predictive score was elaborated based on four parameters: initial levels of beta-hCG, aspects of the image at ultrasound (hematosalpinx, tubal ring or live embryo), size of the mass, vascular flow of the color Doppler. Each parameter received a grade from 0 to 2. Grade 0 represented an unfavorable situation, grade 1 a borderline situation and grade 2 a favorable situation.

RESULTS:

The success rate with a single dose of methotrexate was 75% (30/40). In the present study the cut off grade was 5, because the majority of patients with grade > or = 5 were treated successfully (29/30 - 97%), while those with grade < 5 failed.

CONCLUSION:

The predictive score helps us to indicate the best cases for the medical treatment. Therefore, we do not advise it when the grade is < 5. However, we can predict a good evolution of the treatment when the grade is > or = 5. Federation of Gynecology and Obstetrics.

• Authors: J Elito Jr, A P Reichmann, M N Uchiyama, L Camano
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 67 Issue 2 Pg. 75-9 (Nov 1999) ISSN: 0020-7292 [Print] United States
• PMID: 10636050 (Publication Type: Journal Article)

Chemical References

• Abortifacient Agents, Nonsteroidal
• Chorionic Gonadotropin, beta Subunit, Human
• Methotrexate

Topics

• Abortifacient Agents, Nonsteroidal (administration & dosage, therapeutic use)
• Chorionic Gonadotropin, beta Subunit, Human (analysis)
• Female
• Humans
• Logistic Models
• Methotrexate (administration & dosage, therapeutic use)
• Predictive Value of Tests
• Pregnancy
• Pregnancy, Ectopic (drug therapy)
• Prospective Studies
• Treatment Outcome
• Ultrasonography, Doppler, Color
• Ultrasonography, Prenatal