Tubal Ectopic Pregnancy: Effect of ß-hCG Change in Treatment - (Pages 9-17)
Mehmet Özer1, Yasemin Alan2,* Aşkın Doğan1 and Murat Alan1
1Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and
Gynecology, Izmir, Turkey
2Department of Obstetrics and Gynecology, İzmir Metropolitan Municipality Eşrefpaşa Hospital, İzmir, Turkey
Abstract: Objective: To evaluate the effect of β-hCG of treating prediction in tubal ectopic pregnancies (TEP).
Materials and Methods: 758 patients receiving only one dose of methotrexate (mtx) treatment protocol for CAP were included in the study between January 2009 and December 2017. Patients’ age, gravity, parity, ultrasonography findings, β-hCG values, and factors that may affect treatming process were recorded.
Results: It was determined that medical treatment success was predicted with 77%, 81% sensitivity and 61% and 68% specificity when the initial β-hCG value was 1435 mIU / mL and the β-hCG level on the 4th day was 1539 mIU / mL cut off value. In our study, when β-hCG values decreased by 7% between 0-4 days were taken as cut off value, medical treatment with 84% sensitivity and 77% specificity was shown to be successful. The mean β-hCG levels on the 4th and 7th days were significantly lower in the medical treatment group than in the unsuccessful group.
Conclusion: We found that patients with lower β-hCG values at baseline and day 4 had higher chances of success, and when cut off values were taken as 1435 mIU / mL and 1539 mIU / mL, success rate was significantly decreased. According to β-hCG level on day 0, day 4, and β-hCG change level between 0-4 days, we think ectopic pregnancy approach will decrease the unnecessary hospital stay.
Keywords: Tubal ectopic pregnancies, β-hCG, methotrexate.