Real world data analysis of methotrexate for ectopic pregnancy
Objective:To understand the status quo of methotrexate(MTX)treatment of ectopic pregnancy in the real world through the study of clinical cases of MTX treatment of ectopic pregnancy,so as to better guide the clini-cal standard and reasonable treatment.Methods:The clinical data of patients with pic pregnancy treated with MTX intramaterial injection were analyzed using the electronic medical records of gynecology in Women's Hospital of Nan-jing Medical University from January 2016 to December 2020 as the data source.Results:The total success rate of drug therapy was 81.3％.Most of the single-dose MTX intramuscular injection treatment schemes were used,the actual dose used was mostly lower than the standard dose(50 mg·m-2),and the difference of the actual dose had no effect on the success rate.Follow-up after treatment was not entirely up to standard.The higher the value of ser-um β subunit of human chorionic gonadotropin(β-hCG)before treatment,the lower the success rate of MTX single injection treatment(OR=0.638),and the longer the number of days without menstruation(time from the last men-struation to MTX injection),the higher the success rate of MTX treatment with a single injection(OR=1.570).The decrease of serum β-hCG value in the successful group was significantly higher than that in the failed group on days 4-7 after injection,but there was no significant difference between the successful group and the failed group on days 2 and 3.Conclusion:At present,the management norms of ectopic pregnancy drug therapy have not been strictly implemented,and more attention is needed.The lower serum β-hCG value before injection and the longer period of menopause are important predictors of the success of single MTX treatment.Reexaminations of blood β-hCG values 2 and 3 days after injection do not have good predictive value for the need for subsequent treatment.
万方数据
维普
