การคาดการณ์ผลการรักษาภาวะตั้งครรภ์นอกมดลูก โดยใช้การเปลี่ยนแปลงระดับฮอร์โมนเบต้าเอชซีจี ในวันที่ 4 หลังได้รับยาเมโธเทรกเซที

Panupun Homkrun

doi:10.1016/hscr.v39i1.267987

Authors

Panupun Homkrun Uttaradit hospital

DOI:

https://doi.org/10.1016/hscr.v39i1.267987

Keywords:

ectopic pregnancy, beta-hCG, methotrexate, treatment success

Abstract

ABSTRACT
Objective: To evaluated the association between the change of day 1 to and day 4 post-treatment serum beta human chorionic gonadotropin (beta hCG) changing levels and the predicting methotrexate (MTX) treatment success in ectopic pregnancy.
Methods: Retrospective cohort study was performed in 61 ectopic pregnancy patients who received methotrexate since 1 January 2014 to 31 December 2023. Participants were categorized according to treatment success or treatment failure. Treatment success for this study was defined as beta hCG level on day 7 decreased more than 15% from level on day 4. Changes in day 4 from day 1 beta hCG of both groups were evaluated as predictor of treatment success through receiver operating characteristic
(ROC) curve analysis.
Results: A total of 61 patients with ectopic pregnancy were treated with methotrexate. The treatment success rate was 78.7% (n = 48/61). Beta hCG changing on day 4 can predicted the success of methotrexate treatment with area under the curve 0.904, P-value <0.01, 95% confidence interval 0.812-0.996. Any rise < 11.55% was identified as an optimal cut off with sensitivity 89.6 specificity 84.6 positive
predictive value 95.6 negative predictive value 68.8
Conclusions: The change of day 1 to day 4 post-treatment serum beta human chorionic gonadotropin (beta hCG) levels can predict methotrexate treatment success in ectopic pregnancy with any rise <11.55% was identified as an optimal cut off.
Keywords: ectopic pregnancy/ beta-hCG/ methotrexate/ treatment success

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