{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:55:55Z","timestamp":1792061755624,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Methotrexate (MTX) is an efficient treatment for ectopic pregnancy, used according to \u2018single\u2010dose\u2019 protocol. Treatment success is evaluated on days 4 and 7 after dose administration, and defined as a decline of \u226515% in beta\u2010human chorionic gonadotropin (\u03b2\u2010hCG) levels, with a positive predictive value of 93%. A decrease on day 4 \u03b2\u2010hCG levels was determined to be a good predictor for treatment success. We retrospectively examined changes in \u03b2\u2010hCG levels between days 0 and 4 after MTX treatment as an early predictor for treatment outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The \u2018success group\u2019 consisted of patients with resolved ectopic pregnancy after a single MTX dose and \u2018failure group\u2019 included patients who required additional MTX doses or underwent surgery after the first dose. For each group, demographic and pregnancy data were analyzed as well as initial (admission day), days 0, 4 and 7 \u03b2\u2010hCG levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 159 women included in the study, MTX treatment was successful in 117 patients (73.6%) while 42 patients (26.4%) were defined as treatment failure. In the success group, most patients (58.9%) demonstrated a decrease in \u03b2\u2010hCG values between days 0 and 4 as opposed to the failure group in which an increase in \u03b2\u2010hCG values was observed (76.2%). Decrease of &gt;18% in \u03b2\u2010hCG levels was predictive of treatment success (positive predictive value 92%). Increase in \u03b2\u2010hCG values is less predictive of treatment failure with positive predictive value of 54%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Differences in \u03b2\u2010hCG levels between days 0 and 4 may serve as an early predictor for treatment outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14259","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T09:08:35Z","timestamp":1589447315000},"page":"1104-1109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Early prediction of methotrexate treatment outcome in tubal ectopic pregnancy based on days 0 and 4 human chorionic gonadotropin levels"],"prefix":"10.1111","volume":"46","author":[{"given":"Noy","family":"Shatkin Hamish","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Tendler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avishalom","family":"Sharon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1616-1381","authenticated-orcid":false,"given":"Marwan","family":"Odeh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67103-6"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(86)90838-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1987.6.9.570"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199910000-00018"},{"key":"e_1_2_6_6_1","first-page":"754","article-title":"Single\u2010dose methotrexate for treatment of ectopic pregnancy","volume":"77","author":"Stovall TG","year":"1991","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90687-E"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.07.1775"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.10.014"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.10.007"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.06.013"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del433"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70343-6"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.03.022"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3593-x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03133.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.5152\/jtgga.2013.50133"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.11.138"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2879-8"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjog.14259","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14259","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.14259","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T11:58:58Z","timestamp":1693310338000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.14259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,14]]},"references-count":18,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/jog.14259"],"URL":"https:\/\/doi.org\/10.1111\/jog.14259","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,14]]},"assertion":[{"value":"2019-11-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}