{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:40:39Z","timestamp":1792636839811,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify distinct early beta\u2010human chorionic gonadotropin (\u03b2\u2010hCG) trajectories following single\u2010dose methotrexate (MTX) treatment for tubal ectopic pregnancy and to evaluate their associations with treatment outcomes and potential value for Day\u20107 posttreatment risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included hemodynamically stable patients with confirmed tubal ectopic pregnancy treated with single\u2010dose MTX. Among 828 patients in the all\u2010clinical cohort, 373 had quantitative \u03b2\u2010hCG measurements at Day 0, Day 4, and Day 7 and were included in trajectory modeling. Group\u2010based trajectory modeling was applied to log\u2010transformed \u03b2\u2010hCG values. Multivariable logistic regression evaluated associations with overall treatment failure and clinical treatment failure, while exploratory Day\u20107 risk\u2010stratification analyses assessed model discrimination, calibration, and net benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall treatment failure occurred in 94 of 373 patients (25.2%), and clinical treatment failure occurred in 45 patients. A three\u2010class quadratic model identified a rapid decline class (56.3%), delayed decline class (28.2%), and persistent elevation\/slow decline class (15.5%). Compared with the rapid decline class, the persistent elevation\/slow decline class was associated with higher odds of overall treatment failure (adjusted OR [aOR]\u2009=\u200985.42, 95% CI: 25.64\u2013284.55) and clinical treatment failure (aOR\u2009=\u200952.65, 95% CI: 11.22\u2013246.88), although estimates for clinical failure were imprecise. In the exploratory Day\u20107 model for overall treatment failure, the apparent AUC increased from 0.775 for the base clinical model to 0.862 after adding trajectory class (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Trajectory classes also showed heterogeneity in clinical failure within conventional Day 4\u2013Day 7 \u03b2\u2010hCG response categories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early \u03b2\u2010hCG trajectories were associated with treatment outcomes after single\u2010dose MTX and may complement conventional Day\u20107 posttreatment reassessment. Their clinical utility requires prospective multicenter external validation before routine use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70532","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:35:45Z","timestamp":1792452945000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early \u03b2\u2010\n                    <scp>hCG<\/scp>\n                    Trajectories After Single\u2010Dose Methotrexate Treatment and Their Predictive Value for Treatment Failure in Tubal Ectopic Pregnancy: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"52","author":[{"given":"Juanping","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynecology Dingxi People's Hospital  Dingxi Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5077-7700","authenticated-orcid":false,"given":"Yanni","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Gynecology Dingxi People's Hospital  Dingxi Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0291316"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455057231160349"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12473"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010024\u201007122\u20106"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010020\u201003350\u20108"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2024.2447997"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.04.020"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.920079"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead089"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.10.036"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002560"},{"key":"e_1_2_12_13_1","unstructured":"National Institute for Health and Care Excellence \u201cEctopic Pregnancy and Miscarriage: Diagnosis and Initial Management. NICE Guideline NG126 \u201d2019 last reviewed July 2 2025 accessed June 8 2026 https:\/\/www.nice.org.uk\/guidance\/ng126."},{"key":"e_1_2_12_14_1","unstructured":"National Cancer Institute \u201cCommon Terminology Criteria for Adverse Events (CTCAE) Version 5.0 \u201dpublished November 27 2017 accessed June 8 2026 https:\/\/dctd.cancer.gov\/research\/ctep\u2010trials\/for\u2010sites\/adverse\u2010events\/ctcae\u2010v5\u20105x7.pdf."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7992"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.31923"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2021.09.1046"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2017.10.009"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.16084"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2018.1490406"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.04.030"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15927"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2019.1575344"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70532","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.70532","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70532","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:27:09Z","timestamp":1792636029000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.70532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jog.70532"],"URL":"https:\/\/doi.org\/10.1111\/jog.70532","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70532"}}