{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:03:48Z","timestamp":1785434628067,"version":"3.56.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Ectopic pregnancy (EP) occurs in 2% of gestations. Medical management of stable EP relies on methotrexate (MTX) via intramuscular injection. Guidance is needed to define an optimal dosing regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study from 2016 to 2022 evaluated treatment efficacy for one versus two doses of MTX. Treatment success was defined as \u226515% decline in quantitative serum beta human chorionic gonadotropin (b\u2010hCG) days 4\u20137 after MTX administration. Multivariable logistic regression and Cox proportional hazard models were used to estimate differences in success rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 472 cases were identified, 286 received one dose of MTX, and 186 received two doses. Average age was 31\u2009years, parity 2.3, and body mass index (BMI) 29. Risk factors for EP included prior ectopic (16%) and prior infection (25%). B\u2010hCG at the time of MTX initiation, presence and size of adnexal mass were similar across groups. Treatment success was similar between one dose (72%) and two doses (71%), and no statistically significant differences were observed between groups in adjusted models (odds ratio [OR]\u2009=\u20090.91, 95% confidence interval [CI]: 0.55\u20131.50). Odds of treatment success for one versus two doses was 0.96 (95% CI: 0.59, 1.57), and was unchanged after adjusting for cofounders. Initial b\u2010hCG value and presence of adnexal mass &gt;4\u2009cm were not predictive of treatment response. The rate of laparoscopy was 17% and 11% for one and two doses, respectively. Median time to resolution was 27\u2009days for both treatment groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No significant difference was noted in treatment success, rate of laparoscopy, or total duration of treatment between one or two doses of MTX.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70605","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T10:10:12Z","timestamp":1763547012000},"page":"801-807","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["One versus two doses of methotrexate for the treatment of ectopic pregnancy: A retrospective cohort study at an urban\n                    <scp>US<\/scp>\n                    medical center"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6430-4415","authenticated-orcid":false,"given":"Emma M.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Complex Family Planning Kaiser Permanente Oakland Medical Center  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roselle","family":"Bleck","sequence":"additional","affiliation":[{"name":"Department of Obstrics &amp; Gynecology, Division of Complex Family Planning Columbia University  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Knauer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology and Women's Health Albert Einstein College of Medicine\/Montefiore Medical Center  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Alexandrou","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology and Women's Health Albert Einstein College of Medicine\/Montefiore Medical Center  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savannah Pearson","family":"Ayala","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology and Women's Health Albert Einstein College of Medicine\/Montefiore Medical Center  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth P.","family":"Gurney","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology and Women's Health Albert Einstein College of Medicine\/Montefiore Medical Center  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haotian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences Columbia University Mailman School of Public Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Atrio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology and Women's Health Albert Einstein College of Medicine\/Montefiore Medical Center  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002560"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90687-E"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.061"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.06.054"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2017.01.004"},{"key":"e_1_2_9_8_1","first-page":"332","article-title":"Single\u2010dose versus two\u2010dose administration of methotrexate for the treatment of ectopic pregnancy: a randomized controlled trial","volume":"31","author":"Song T","year":"2016","journal-title":"Hum Reprod"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.08.009"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.5812\/ircmj.20147"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200304000-00028"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.01.002"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_15_1","unstructured":"R Core Team.R: A Language and Environment for Statistical Computing.2023R Foundation for Statistical Computing Vienna Austria.https:\/\/www.R\u2010project.org\/"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.11.055"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2005.24.5.591"}],"container-title":["International Journal of Gynecology &amp; 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