Objective:
To determine necessary parameters to decide the second treatment for those whofailed a single dose methotrexate therapy.
Material and methods:
32 ectopic pregnancy patients who fail a single dose methotrexate treatment between 2000 and 2010 have been divided into two groups for secondary treatment; surgical and medical treatments. Clinical and laboratory characteristics of the patient groups were compared.
Results:
23 patients were treated surgically and medical treatment was repeated in 9 patients. There was no difference in terms of gestational age, baseline serum ß-hCG level and the size of ectopic pregnancy for both surgical and medical treatment of the patients. Surgery was performed in all patients who developed hemodynamic instability. Serum ß-hCG values were significantly higher in patients with hemodynamic instability than those who are hemodynamically stable (10374±14.554 vs. 4225±3429, p:0.001).
Conclusion:
The most important parameter is hemodynamic instability to decide the second treatment for those failed a single dose methotrexate therapy.
Keywords: Ectopic pregnancy, methotrexate, hemodynamic stability, ß-hCG