The importance of the change in B-HCG values ​​in the last 48 hours before treatment and on the 4th day after treatment in predicting the success of single-dose methotrexate treatment in tubal ectopic pregnancy.

OBJECTIVE: To predict early treatment success and to direct the treatment in patients who received single-dose methotrexate treatment in tubal ectopic pregnancy. MATERIAL-METHODS: The files and records of patients who applied to our clinic with the diagnosis of tubal ectopic pregnancy between January 2017 and May 2022 and treated single-dose MTX treatment were retrospectively analyzed. 97 patients in total were included in the study. β-HCG value measured just 48 hours before MTX treatment, inlet β-HCG value taken just before the treatment (β-HCG value on day 1), β-HCG value taken on 4th day of treatment and β-HCG value taken on 7th day of treatment were noted. 97 patients included in the study were divided into 2 groups. Patients were divided into groups according to treatment efficiency. In these patients, the rate of change in ß-HCG value on 48 hours before MTX treatment and on the 1st and 4th days of MTX treatment was statistically calculated using SPSS and according to %15 decrease of β-HCG value between the 4th day and on the 7th day success of the routine treatment; Prediction power was calculated with the value on 48 hours before treatment and the proportional/ percentage change on the 1st and 4th days of treatment. RESULTS: It was observed that a single-dose of MTX treatment was successful in 78.4% of the cases and failed in 21.6%. The initial β-HCG value of the cases with successful single-dose MTX treatment was found to be statistically significantly lower than the cases who failed treatment. (p=0,04) The average percentage of increase in ß-HCG value on 48 hours before the treatment compared to the 1st day was determined as %14 in successful cases. The percentage of increase in ß-HCG value on 48 hours before the treatment was determined %23 in unsuccessful cases. It was observed that the cut-off point for the ß-HCG value on 48 hours before the treatment was ≤12,5 in the successful cases. 55 The percentage change in the β-HCG value on the 4th day compared to the first day of treatment in cases who were successful in a single dose MTX treatment was found to be statistically significantly lower than the cases whose treatment was not successful (p = 0,01). CONCLUSION: In tubal ectopic pregnancy cases given single-dose methotrexate treatment, for those with ß-HCG increase percentage of ≤12.5 in the 48 hours before treatment were found to be more successful. It was determined that the percentage of change in ß-HCG value between the 1st and 4th days tended to decrease in patients with successful treatment.