Determining the Factors Predicting the Success of Medical Management in Patients with Ectopic Pregnancy : Medical management in patients with ectopic pregnancy.

Abstract

Background: Ectopic pregnancy is considered the most common cause of pregnancy-related deaths in the first trimester. Methotrexate is recognized as an effective drug for the treatment of ectopic pregnancy. The aim of this study was to determine the associated and predictive factors for success in medical treatment among patients with ectopic pregnancy (EP).

Materials and methods: After collection of Demographic information, serum β-hCG levels and ultrasound findings were evaluated and compared between two groups: those with successful medical treatment and those without.

Results: The mean β-hCG level have not significant difference between the two groups (P=0.806). The frequency of previous IUD use in the successful treatment group was 8%, while there were no cases in the failure group; however, this difference was not statistically significant (P=0.547). The frequency of prior EP, the observed frequency of hematoma and the frequency of tubal ring observation, which also showed no significant difference (respectively P=0.9, P=0.9 and P=0.111). Logistic regression analysis revealed that none of the investigated variables were significant predictors of treatment success. However, the presence of a tubal ring (OR: 6.500, 95% CI: 0.799-52.897, p = 0.080) and increased endometrial thickness (OR: 1.317, 95% CI: 0.971-1.786, p = 0.077) showed borderline significance. Commonly considered factors, such as gestational age, β-hCG levels, patient age, parity, and gravidity, did not significantly influence treatment success. The study highlights a high success rate for single-dose methotrexate therapy and the potential utility of tubal ring and endometrial thickness as clinical indicators, warranting further investigation.

Conclusion: The results of this study indicate that single-dose methotrexate treatment for tubal ectopic pregnancy leads to a high success rate. Given the sample size of this study, none of the variables had a significant impact on treatment success or predictive power.