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document
Comparison of double- and single-dose methotrexate protocols for treatment of ectopic pregnancy . OBJECTIVE To compare efficacy between double-dose methotrexate and single-dose methotrexate for treatment of tubal ectopic pregnancy ( EP ) . METHODS Between March 2008 and February 2011,157 patients who had tubal EP diagnosed by a non-laparoscopic approach and were hemodynamically stable were enrolled in a prospective study in Qassim , Saudi Arabia . The participants were randomized to receive either double-dose ( 50mg/m ( 2 ) intramuscularly on days 0 and 4 ; group 1 ) or single-dose ( 50mg/m ( 2 ) intramuscularly on day 0 ; group 2 ) methotrexate . Serum human chorionic gonadotropin ( β-hCG ) levels were followed until negative . RESULTS The overall success rate was comparable between groups 1 and 2 ( 88.6 % versus 82.0 % , P=0.1 ) . The duration of follow up until negative β-hCG was shorter in group 1 ( P=0.001 ) . Receiver operative characteristics showed that higher cut-off levels of β-hCG and gestational mass diameter were associated with successful outcome in group 1 . Among participants with initial β-hCG of 3600-5500 mIU/mL , the success rate was higher in group 1 ( P=0.03 ) . There was no significant difference between groups in adverse effects . CONCLUSION For treatment of EP , double-dose methotrexate had efficacy and safety comparable to that of single-dose methotrexate ; it had better success among patients with moderately high β-hCG and led to a shorter follow up .
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Intervention_Pharmacological
methotrexate
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Intervention_Pharmacological
methotrexate
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Intervention_Pharmacological
methotrexate
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Intervention_Pharmacological
methotrexate
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Outcome_Other
overall success rate
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Outcome_Adverse-effects
adverse effects
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Participant_Sample-size
2011,157
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Participant_Condition
tubal EP