Comparison of alternative βhCG follow-up protocols after single-dose methotrexate therapy for tubal ectopic pregnancy

@article{kr2017ComparisonOA,
  title={Comparison of alternative $\beta$hCG follow-up protocols after single-dose methotrexate therapy for tubal ectopic pregnancy},
  author={Yavuz Emre Ş{\"u}k{\"u}r and Kazibe Koyuncu and Mehmet Murat Seval and Esra Çetinkaya and Fulya D{\"o}kmeci},
  journal={Archives of Gynecology and Obstetrics},
  year={2017},
  volume={296},
  pages={1161-1165},
  url={https://api.semanticscholar.org/CorpusID:3727675}
}
Any βhCG decrease between days 0/1 and 7’ protocol may substitute the currently used one to decide second dose methotrexate in tubal EP management, and omitting 4th day measurement seems to be more convenient and cost effective.
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Various BhCG monitoring protocols for predicting the success of single-dose methotrexate in the treatment of ectopic pregnancy

The importance of fourth-day BhCG for measuring the success of single-dose methotrexate therapy was identified, and after randomised, multicentre, prospective clinical trials, the most common follow-up protocol can be changed to a single- dose methotRexate therapy for ectopic pregnancy.

Alternative beta-hCG follow-up protocols after single-dose methotrexate therapy for ectopic pregnancy: A retrospective cohort study.

The effect of ultrasonography in predicting medical treatment success in ectopic pregnancy

The effect of ectopic pregnancy mass size on medical treatment prediction was investigated in cases with mass size less than 40mm, finding that even if it is below 40 mm, it may not indicate the medical treatment success.

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Single-dose intramuscular methotrexate appears to be an effective medical treatment for the unruptured ectopic pregnancy of 3.5 cm or less in greatest dimension with or without cardiac activity.

βhCG monitoring after single‐dose methotrexate treatment of tubal ectopic pregnancy: Is the Day 4 βhCG necessary? A retrospective cohort study

In ectopic pregnancy (EP) management, failure of βhCG to fall more than 15% between Days 4 and 7 after methotrexate administration indicates the need for a second dose. Regimens preferring a 25% fall…

Using a decline in serum hCG between days 0–4 to predict ectopic pregnancy treatment success after single-dose methotrexate: a retrospective cohort study

It is verified that a decline in serum hCG between days 0–4 after methotrexate treatment for ectopic pregnancies, with pre-treatment serum h CG levels ≤3000 IU/L, provides an early indication of likelihood of treatment success, and performs just as well as the existing measure, which only provides prognostic information on day 7.

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It is confirmed that a 15% decrease in serum hCG between day 4 and day 7 is a very good indicator of the likely success of MTX, and new rules developed did not outperform the current 15% day 4-7 rule.

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Less than 22 % reduction in human chorionic gonadotropin levels from day 1 to 4 can be used as a predictive factor for the requirement of an additional dose of methotrexate in single-dose regimen.

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The reasons for the reported increase in pregnancy-related mortality are unclear; possible factors include an increase in the risk of women dying, changed coding with the International Classification of Diseases, and the addition by states of pregnancy checkboxes to the death certificate.