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

## TL;DR

This study examines factors that predict the success of methotrexate treatment for ectopic pregnancy and finds no significant predictors among the variables tested.

## Contribution

The study contributes by analyzing clinical indicators like tubal ring and endometrial thickness as potential predictors for treatment success.

## Key findings

- Single-dose methotrexate therapy showed a high success rate for treating ectopic pregnancy.
- Variables like β-hCG levels, gestational age, and prior ectopic pregnancy did not significantly influence treatment success.
- Tubal ring and endometrial thickness showed borderline significance as potential indicators.

## Abstract

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).

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.

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.

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.