Prediction of methotrexate treatment outcome in tubal ectopic pregnancy based on days 0 and 4 and 7 Human Chorionic Gonadotrophin Levels

Shaimaa Wasfi  Mahmood; Salama Kamil  Nasir

doi:10.56056/amj.2025.366

Authors

Shaimaa Wasfi Mahmood MBChB, KBMS/Obstetrics and Gynecology trainee; Sulaymaniyah Maternity Teaching Hospital-Sulaymaniyah-Kurdistan Region/Iraq.
Salama Kamil Nasir Assistant Professor in Obstetrics and Gynecology Department at Medical College-Sulaymaniyah University-Kurdistan Region/Iraq

DOI:

https://doi.org/10.56056/amj.2025.366

Keywords:

Beta-Human Chorionic Gonadotrophin, Early prediction, Methotrexate, Tubal ectopic, Treatment success

Abstract

Background and objective: Methotrexate is highly effective in treating ectopic pregnancy with a single dose. Effectiveness is evaluated on days 4 and 7, successful outcome defined as a 15% decrease in beta-Human Chorionic Gonadotrophin levels. The aim of the study is the evaluation of Methotrexate's effectiveness in treating tubal ectopic pregnancy by tracking beta-Human Chorionic Gonadotrophin levels on day 0 and day 4.

Methods: A cohort study was conducted on 55 individuals diagnosed with tubal ectopic pregnancy at Sulaymaniyah Maternity Teaching Hospital Kurdistan region, Iraq from May 2022 to May 2023. Data was collected from medical files and ultrasound assessments, monitoring the participants' beta-Human Chorionic Gonadotrophin after methotrexate administration.

Results: On the first day of methotrexate treatment, ectopic mass sizes ranged from 10 × 20 to over 30, decreasing to 8 × 20 to over 20 by the seventh day. Beta-Human Chorionic Gonadotrophin levels on days 1, 4, and 7 were 1499.34, 1220.877, and 796.21, respectively, showing significant changes (p<0.001). Methotrexate treatment success rate was 69.8%, However, a significant correlation was found between treatment outcome and ectopic sizes on days 1 and 7 (p=0.000 and p<0.000, respectively). Treatment outcome was also significantly related to beta-Human Chorionic Gonadotrophin levels on day zero (p=0.007), burst not on days 4 or 7 (p>0.05).

Conclusion: Methotrexate is an effective treatment for tubal ectopic pregnancy, with beta-Human Chorionic Gonadotrophin levels as a reliable marker for predicting outcome.

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