ArticlePloS one2022
Time to resolution of tubal ectopic pregnancy following methotrexate treatment: A retrospective cohort study.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Methotrexate in relatively contraindicated ectopic pregnancies: who benefits from treatment?Archives of gynecology and obstetrics · 2026Article
- Exploring midwifery role and scope in acute early pregnancy care: a survey of midwives and midwifery students in Australia.BMC pregnancy and childbirth · 2025Article
- Ectopic pregnancy.Nature reviews. Disease primers · 2024Review
- The Utility of Monitoring Beta-Human Chorionic Gonadotropin Levels in an Ectopic Pregnancy.Cureus · 2023Review
- The Very First Romanian Unruptured 13-Weeks Gestation Tubal Ectopic Pregnancy.Medicina (Kaunas, Lithuania) · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the time to resolution of tubal ectopic pregnancy after methotrexate treatment.
methodsA 14-year retrospective cohort study was performed from 2004-2018 and assessed 216 women treated with single-dose methotrexate for tubal ectopic pregnancy. Women were treated using a single-dose protocol of intramuscular methotrexate (50mg/m2) for confirmed tubal ectopic pregnancy on ultrasound. Ectopic pregnancies were included if the ectopic pregnancy mass was <35mm, no evidence of rupture and no embryonic cardiac activity. Serum hCG was measured on day 1, 4 and 7 of treatment and then at standard weekly intervals until resolution. Where there was not a ≥15% decline in hCG from day 4 and day 7, a second dose of methotrexate was administered. The primary outcome was time to resolution (days), with serum hCG <5 IU/L considered resolved. The secondary outcome was need for rescue surgery.
resultsAmong women who did not proceed to surgery, the median time to resolution was 22 days (IQR 14,34). Time to resolution and need for rescue surgery increased with baseline hCG. When hCG was <1000 IU/L, the median was 20 days (IQR 13,29) but 34.5 days (IQR 22,48) with hCG >2000 IU/L. Early hCG trends were predictive of time to resolution and likelihood of rescue surgery; a hCG rise of >1000 IU/L between Days 1-4 increased time to resolution to 61 days (IQR 35,80) and an odds ratio of rescue surgery of 28.6 (95% C.I. 5.3,155.4).
conclusionThe median time to resolution for ectopic pregnancies treated with methotrexate is 22 days and associated with baseline hCG levels. The predictive value of baseline hCG may be useful in clinical decision making and counselling women considering methotrexate for ectopic pregnancy.
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