Role of various complete blood count parameters in predicting the success of single-dose Methotrexate in treating ectopic pregnancy

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 2014 and December 2016. 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.

Association Between White Blood Cells at Baseline and Treatment Failure of MTX for Ectopic Pregnancy

“…Some studies have also found an association between inflammation-related indicators and treatment. Several inflammation-related indicators can be related to the efficacy of MTX, such as neutrophil-lymphocyte ratio (NLR), plateletlymphocyte ratio (PLR), platelet distribution width (PDW), platelet mean volume (MPV), and platelet count (PLT) (9)(10)(11). White blood cell (WBC) count, as the most common and important test index for evaluating inflammation in clinical practice, is often measured for each patient on the first day of admission.…”

The effect of ultrasonography in predicting medical treatment success in ectopic pregnancy

“…The early prediction of medical treatment success in ectopic pregnancy has been frequently studied in the literature [2,4,12,13]. An ectopic pregnancy mass size of 40 mm, which is accepted by many others and recommended by ACOG , is a limit for selecting surgical methods in the treatment of ectopic pregnancy.…”

“…There are many studies on the success of medical therapy in the treatment of ectopic pregnancy [2,4,12,13]. In our study , it was aimed whether the EP mass size less than 40 mm detected by ultrasonography and the adnexal side on which it was located had an effect on the success of medical treatment.…”

“…Delays in the diagnosis of ectopic pregnancy may result in mortality, and ruptured ectopic pregnancy-related hemorrhage is observed at 2.7 % among pregnancy-related deaths [3]. Ectopic pregnancy is located often in the fallopian tube and rarely ovarian, cesarean scar, abdominal and cervical [4].…”

“…Laparatomy or laparoscopy is planned in patients with unstable hemodynamic and MTX failure or MTX contraindications [8]. Treatment success in a single dose MTX regimen is decided by more than 15 % β-hCG reduction in the 4th and 7th days after administration of 50mg / m² of medication [4,9]. Two doses, multiple doses, leukoverine or mifepristone are also included with MTX regimens [10].…”