Title : Efficacy of methotrexate treatment in ectopic pregnancy: A retrospective cohort study
Abstract:
Ectopic pregnancy, a potentially life-threatening condition where fertilized eggs implant and develop outside the uterus, presents considerable risks to maternal health. This retrospective cohort study, conducted at BronxCare Hospital between January 2020 and September 2022, focused on 101 patients diagnosed with tubal ectopic pregnancies. Ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterine cavity, typically in the fallopian tubes but can also occur in other locations such as the ovaries or cervix. Methotrexate (MTX), a medication commonly used to terminate ectopic pregnancies, was administered to eligible participants. Criteria for diagnosis and treatment outcomes were established, with statistical analysis performed using SPSS Version 23.0.
The results revealed a 74.2% success rate with MTX treatment (Group A), while 25.7% required surgical intervention (Group B), with a particular emphasis on cases where initial β-hCG levels exceeded 3000 IU/L. Demographic characteristics and risk factors were analyzed, uncovering significant differences in β-hCG levels between the two groups on days 0, 4, and 7. Factors such as age, previous ectopic pregnancies, and gestational age at diagnosis were also assessed for their impact on treatment outcomes.
This study provides valuable insights into the efficacy of MTX treatment and associated factors in managing tubal ectopic pregnancies, shedding light on optimal strategies for patient care and highlighting the importance of early detection and intervention in mitigating risks to maternal health. Further research is warranted to explore additional predictors of treatment success and refine treatment protocols for improved patient outcomes.
Audience Take Away:
- Improved medical management of patients with ectopic pregnancy.
- Reduction in morbidity related to emergency surgery for ectopic pregnancy by identifying patients likely to fail medical management earlier.
- Enhanced informed consent for patients, allowing them to understand the impact of their β-hCG levels on the failure of medical management.
- Our study reveals that a β-hCG level lower than current guidelines is associated with failure of medical management, suggesting a need for reevaluation of existing protocols and potentially prompting further research in this area.
- Other faculty could utilize this research to explore different protocols of medical management beyond a single dose of methotrexate, thus expanding the scope of their research or teaching.
- This research provides insight into how β-hCG levels impact the failure of medical treatment, offering a practical solution for medical professionals to optimize medical management approaches for ectopic pregnancy, potentially simplifying their job and improving efficiency.
- It will likely improve the accuracy of design in medical management approaches for ectopic pregnancy by considering the impact of β-hCG levels on treatment failure, providing new information to assist in addressing this clinical problem.
