Success Rate of Single-Dose Regimen of Methotrexate Treatment in Ectopic Pregnancy at Ramathibodi Hospital: Twelve-Year Experience
Naruemon Chompinit MD1, Woradej Hongsakorn MD1, Chananya Tantitham MD1, Srithean Lertvikool MD1, Yada Tingthanatikul MD1, Apichart Chittacharoen MD1
Affiliation : 1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate the success rate of single-dose intramuscular methotrexate [MTX] regimen for the treatment of ectopic
pregnancy at Ramathibodi Hospital and identify predictive factors of treatment success.
Materials and Methods : The present study was a retrospective observational study of 141 patients diagnosed as ectopic pregnancy
and treated by single-dose MTX regimen at Ramathibodi Hospital between October 2005 and September 2017.
Results : Of the 141 patients included in the present study, the authors found 103 patients were successfully treated with single-
dose MTX regimen (overall success rate 73.05%). The factors related to successful MTX treatment were pretreatment β-hCG level
less than 3,000 mIU/ml (OR 3.07, 95% CI 1.20 to 7.84) and the decrease of β-hCG level on day 4 compared with day 0 (OR 7.45,
95% CI 2.84 to 19.58).
Conclusion : The single dose MTX regimen is a safe and effective treatment for ectopic pregnancy after a proper patient selection.
The pretreatment β-hCG level and the change of β-hCG level between day 0 and day 4 are the important predictive factors that can
predict the success of the treatment.
Keywords : Ectopic pregnancy, Methotrexate, Success rate
