Increment in beta-hCG in the 48-h period prior to treatment: a new variable predictive of therapeutic success in the treatment of ectopic pregnancy with methotrexate

Increment in beta-hCG in the 48-h period prior to treatment: a new variable predictive of therapeutic success in the treatment of ectopic pregnancy with methotrexate

Autor Soares, Roberto da Costa Autor UNIFESP Google Scholar
Elito, Julio Autor UNIFESP Google Scholar
Camano, Luiz Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Univ Technol & Sci FTC
Resumo Background To evaluate the increment in beta-hCG levels (%) in the 48-h interval prior to treatment as a predictor of therapeutic success in the management of ectopic pregnancy with methotrexate.Methods A prospective observational study was carried out between April 2002 and November 2006 at the Federal University of São Paulo in 65 patients with an ectopic pregnancy treated with a single dose of 50 mg/m(2) of methotrexate administered intramuscularly. the following predictive factors were evaluated: beta-hCG level on the day of hospital admission and the percent increment in beta-hCG in the 48-h interval prior to treatment.Results Treatment was successful in 49 cases (75.4%). in these cases, beta-hCG levels at hospitalization were lower when compared to the levels found in cases of therapeutic failure (1,928.9 vs. 4,828.6 mIU/ml, respectively; P < 0.01), and the increment in beta-hCG level in the 48-h interval prior to treatment was smaller (13.1 vs. 36.3%, respectively; P = 0.01). A beta-hCG measurement <= 2,685 mIU/ml on the day of hospitalization and an increment in beta-hCG level <= 11.1% in the 48 h preceding treatment were factors indicative of therapeutic success with sensitivity of 79.6 and 61.7%, respectively, and specificity of 75 and 81.3%, respectively.Conclusions the lower the beta-hCG measurement on the day of hospital admission and the lower its increment in the 48-h interval prior to treatment, the greater the likelihood that treatment of ectopic pregnancy with methotrexate will be successful. the margin of safety for treatment with methotrexate is high when beta-hCG measurement on the day of hospitalization is <= 2,685 mIU/ml and its increment in the 48 h prior to treatment is <= 11.1%.
Palavra-chave ectopic pregnancy
medical treatment
methotrexate
beta-hCG
Idioma Inglês
Data de publicação 2008-10-01
Publicado em Archives of Gynecology and Obstetrics. Heidelberg: Springer Heidelberg, v. 278, n. 4, p. 319-324, 2008.
ISSN 0932-0067 (Sherpa/Romeo, fator de impacto)
Publicador Springer
Extensão 319-324
Fonte http://dx.doi.org/10.1007/s00404-008-0589-4
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000258600700004
Endereço permanente http://repositorio.unifesp.br/handle/11600/30937

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