Volume : 10, Issue : 04, April – 2023
Title:
21.OUTCOME OF METHOTREXATE IN TREATING ECTOPIC PREGNANCY
Authors :
Dr. Amna Jabbar, Dr. Iqra Habib, Dr. Sobia Zafar
Abstract :
Objective: The protocol of 15% BhCG decrease between Days four and seven is frequently used for evaluating the success of methotrexate administration in treating ectopic pregnancy. Our objective was to study the usage of hematologic parameters for evaluating the success of methotrexate administration in treating ectopic pregnancy.
Method: This study was conducted between February 2021 and December 2022. Data of 434 patients were retrospectively scanned for the study. One hundred sixty-one patients whose Day one, four and seven results were recorded in the hospital information system and who were followed up until their BhCG levels decreased <10 IU/L were enrolled in the study. Three types of complete blood cell count parameters of the patients were used: 1) Neutrophil-to-lymphocyte ratio (NLR). 2) Platelet distribution width (PDW), 3) Platelet count (PLT).
Results: Patients were separated into two groups as those who were treated with single-dose methotrexate and those who required surgical treatment. A significant difference was detected between the groups in terms of NLR levels on Days 1, 4, and 7 (p=0.012, p=0.035, and p=0.001, respectively). There was no significant difference detected between the groups for PDW and PLT counts on Days one, four and seven. Conclusions: NLR can also be used as an alternative to BhCG for evaluating the success of single-dose methotrexate administration in treating ectopic pregnancy. However, there is need for further studies on this topic.
Cite This Article:
Please cite this article in press Amna Jabbar et al, Outcome Of Methotrexate In Treating Ectopic Pregnancy., Indo Am. J. P. Sci, 2023; 10 (04).
Number of Downloads : 10
References:
1. Hajenius PJ, Mol F, Mol BWJ, Bossuyt PMM, Ankum WM, Van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;1:CD000324. doi: 10.1002/14651858.CD000324.pub2.
2. Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. Can Med Assoc J. 2005;173(8):905-912. doi: 10.1503/cmaj.050222.
3. Stovall TG, Ling FW, Buster JE. Outpatient chemotherapy of unruptured ectopic pregnancy. Fertil Steril. 1989;51(3):435-438.
4. Stovall TG, Ling FW, Gray LA. Single-dose methotrexate for treatment of ectopic pregnancy. Obstet Gynecol. 1991;77(5):754-757.
5. Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: A meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynecol. 2003;101(4):778-784.
6. Kirk E, Condous G, Van Calster B, Haider Z, Van Huffel S, Timmerman D, et al. A validation of the most commonly used protocol to predict the success of single-dose methotrexate in the treatment of ectopic pregnancy. Hum Reprod. 2007;22(3):858-863. doi: 10.1093/humrep/del433.
7. Rausch ME, Barnhart KT. Serum biomarkers for detecting ectopic pregnancy. Clin Obstet Gynecol. 2012; 55(2):418-423. doi: 10.1097/GRF.0b013e31825109f6.
8. Senapati S, Sammel MD, Butts SF, Takacs P, Chung K, Barnhart KT. Predicting first trimester pregnancy outcome: derivation of a multiple marker test. Fertil Steril. 2022;106,(7):1725-1732.e3. doi: 10.1016/j. fertnstert.2022.08.044.
9. Turgut A, Sak ME, Ozler A, Soydinc HE, Karacor T, Gul T. Alteration of peripheral blood cells in tubal ectopic pregnancy. Ginekol Pol. 2013;84(3):193-196.
10. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010;14(1):28-32.
11. Smith TL, Weyrich AS. Platelets as Central Mediators of Systemic Inflammatory Responses. Thromb Res.
2011;127(5):391-394. doi: 10.1016/j.thromres.2010.10.013.
12. Li Z, Yang F, Dunn S, Gross AK, Smyth SS. Platelets as immune mediators: Their role in host defense responses and sepsis. Thromb Res. 2011;127(3):184-188. doi: 10.1016/j.thromres.2010.10.010.
13. Muhmmed Suliman MAR, Bahnacy Juma AA, Ali Almadhani AA, Pathare AV, Alkindi SSA, Uwe Werner F. Predictive Value of Neutrophil to Lymphocyte Ratio in Outcomes of Patients with Acute Coronary Syndrome. Arch Med Res. 2010;41(8):618-622. doi: 10.1016/j.arcmed.2010.11.006.
14. Akkaya H, Uysal G. Can hematologic parameters predict treatment of ectopic pregnancy? Pak J Med Sci. 2022;33(4):937-942. doi: 10.12669/pjms.334.12418.
15. Karaman E, Cim N, Alkis I, Yildizhan R, Elci G. Evaluation of mean platelet volume in unruptured ectopic pregnancy: A retrospective analysis. J Obstet Gynaecol (Lahore). 2022;36(5):622-625. doi: 10.3109/01443615.2021.1131974.
16. Artunc Ulkumen B, Pala HG, Calik E, Oruc Koltan S. Can Mean Platelet Volume and Platelet Distribution Width be Possible Markers for Ectopic Pregnancy and Tubal Rupture? (MPV and PDW in Ectopic Pregnancy). Pak J Med Sci.
2021;30(2):352-355.