KẾT QUẢ ĐIỀU TRỊ NỘI KHOA CHỬA NGOÀI TỬ CUNG TẠI BỆNH VIỆN PHỤ SẢN HÀ NỘI

Abstract

Objective: To evaluate the treatment outcomes of patients with ectopic pregnancy managed medically with Methotrexate (MTX) at Hanoi Obstetrics and Gynecology Hospital. Methods: A retrospective cross-sectional study was conducted on 131 patients with ectopic pregnancy treated medically with Methotrexate at Hanoi Obstetrics and Gynecology Hospital from January 2022 to June 2023. Results: The overall success rate of medical treatment was 84.0%. Among them, 80/131 patients received a single dose of MTX, 41/131 received two doses, and 10 received three doses. A total of 21/131 (16.0%) patients experienced treatment failure and underwent laparoscopic removal of the ectopic mass. The success rate in patients with pre-treatment βhCG ≤ 1000 IU/L was 82.7%, decreasing progressively with higher initial βhCG levels: 76.5% for 1001–2000 IU/L and 60.0% for >2000 IU/L. Notably, both patients with βhCG >3000 IU/L prior to treatment failed medical management. In cases where βhCG on day 4 decreased ≥50% compared to day 1, the success rate was 96.7%; conversely, if βhCG on day 4 increased >30%, the success rate dropped to 58.6%. The greater the decline in βhCG from day 4 to day 7, the higher the success rate. Patients with a ≥30% decrease from day 4 to day 7 had a success rate of 95.2%, while those with a <15% decrease had a success rate of 79.4%. Only 3.1% of patients reported other adverse effects during medical treatment. Conclusion: Medical management of ectopic pregnancy at Hanoi Obstetrics and Gynecology Hospital achieved a success rate of 84.0%, with minimal recorded side effects. Patients may require 1 to 3 doses of MTX. The initial βhCG level and the rate of βhCG decline during the first week are important prognostic factors.