Evaluation of a follow-up customized strategy for women treated with methotrexate for an ectopic pregnancy: An observational study

• Published in: European journal of obstetrics & gynecology and reproductive biology 2019-05, Vol.236, p.32-35
• Main Authors: Barbier, Magalie, Pivano, Audrey, Tourette, Claire, Poizac, Sabine, Cravello, Ludovic, Boubli, Leon, Agostini, Aubert
• Format: Article
• Language: English
• Subjects: Abortifacient Agents, Nonsteroidal - therapeutic use; Adult; Aftercare - methods; Aftercare - statistics & numerical data; Ectopic pregnancy; Female; Follow-Up strategy; Humans; Methotrexate; Methotrexate - therapeutic use; Precision Medicine; Pregnancy; Pregnancy, Ectopic - drug therapy; Young Adult
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2019.02.037

To evaluate a follow-up customized strategy used in women treated with methotrexate for tubal ectopic pregnancy. This observational monocentric study took place from November 2009 to December 2015 in the emergency unit at La Conception University Hospital in Marseille, France. 440 women were treated by methotrexate for tubal ectopic pregnancy. Women were assigned in a classic follow up protocol with a weekly hCG evaluation (conventional protocol) if the drop in hCG between D1 and D4 was inferior to 20% or in an alternative follow up (streamlined protocol) with a hCG evaluation at one month. The main outcome measures were the success rate, the proportion of women requiring several methotrexate injections, and the mean number of consultations per women and duration of the follow-up. During this period, the success rate was 348/440 (79.1%). The rate of women requiring 1, 2, or 3 injections and of women lost to follow-up were comparable between the two protocols. The mean number of consultations per woman was 3.6 ± 1.33 vs. 5.95 ± 2.25 days (p