PROGNOSTIC VALUE OF THE DAY-7 TO DAY-1 𝛃-HCG RATIO IN THE TREATMENT OF UNRUPTURED ECTOPIC PREGNANCY WITH SINGLE- DOSE METHOTREXATE AT CAN THO OBSTETRICS AND GYNECOLOGY HOSPITAL IN 2024-2026
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Abstract
Background: Unruptured ectopic pregnancy is a common obstetric emergency in clinical practice, especially in women of reproductive age. If detected early when the patient is hemodynamically stable, medical treatment with a single dose of Methotrexate is considered an effective conservative method, avoiding surgery and help preserve natural fertility. However, post– treatment monitoring plays a crucial role in assessing response and early detection of treatment failure. Objective: To evaluate the prognostic value of the β-hCG ratio on day 7 versus day 1 in the treatment of unruptured ectopic pregnancy with a single dose of Methotrexate. Materials and methods: A single– cohort study was conducted on 141 patients with ectopic pregnancy treated with a single dose of Methotrexate at Can Tho Obstetrics and Gynecology Hospital from 2024 to 2026. Results: The mean age was 30.96 ± 6.371, the 20–35 age group accounted for 71.6%. Common symptoms included delayed menstruation (61.7%), vaginal bleeding (72.3%), and abdominal pain (70.2%). The highest percentage of β-hCG levels ranged from 1000–3000 mIU/ml (57,4%). The success rate after a single dose of Methotrexate was 61%, the overall success rate was 91.5%. A βhCG reduction of ≥10.6% from day 1 to day 7 had a positive predictive value of 90.8%, sensitivity of 80,2%, and specificity of 87.3% (p<0.001). Conclusion: Single– dose Methotrexate is an effective treatment for unruptured ectopic pregnancy. A decrease in β-hCG of ≥10,6% between day 1 and day 7 is a reliable prognostic factor and can be used in monitoring and predicting treatment outcomes.
Keywords
Ectopic pregnancy, Methotrexate, single dose, treatment outcome
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