AI Article Synopsis
- Women with a history of ectopic pregnancy (EP) were studied to see if it increased the risk of treatment failure with a two-dose methotrexate (MTX) protocol.
- In a study of 234 women, those with prior EP had an increased risk of MTX failure in initial analysis, but this was not significant when accounting for other factors.
- The findings suggest that previous EP does not independently affect MTX failure rates when treating new episodes of EP with a two-dose approach.
Article Abstract
Objective: Women with prior ectopic pregnancy (EP) have an increased failure rate when treated with single-dose methotrexate (MTX) for subsequent EP. We sought to determine whether previous EP remained a risk factor for failure when using the two-dose MTX protocol.
Study Design: Retrospective cohort study of women managed with two-dose MTX. Risk factors for MTX failure were evaluated in univariable analysis and multivariable regression modeling.
Results: A total of 234 women with EP between 1999 and 2009 were studied. Of those, 37 (15.8%) had a prior EP. In univariable analysis, prior EP was associated with a greater than twofold increased risk of MTX failure (RR 2.67, 95% CI 1.20-3.77). Higher hCG levels and ultrasound visualization of EP also increased the risk of MTX failure. In multivariable analysis hCG level remained associated with MTX failure, while prior EP did not (adjusted RR 0.97, 95% CI 0.33-2.82).
Conclusion: Prior EP is not independently associated with MTX failure in women receiving two-dose MTX therapy after controlling for known risk factors.
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