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Gynaecology & Obstetrics Ecotopic Pregnancy fea48586

Regarding medical treatment of ectopic pregnancy, all are true except:

A
Initial beta HCG is an indicator for the number of doses required
B
Failure rates increases if cardiac activity is present
C
Best prognostic indicator for success is initial HCG levels
D
Perform baseline CBC, LFT, KFT
High-Yield Explanation
Ans. A. Initial beta HCG is an indicator for the number of doses requiredThe best candidate for medical therapy in unruptured tubal ectopic is the woman who is asymptomatic, motivated, and compliant. With medical therapy, some classic predictors of success include a low initial serum beta hCG level, small ectopic pregnancy size, and absent fetal cardiac activity. Of these, initial serum beta hCG level is the single best prognostic indicator of successful treatment with single-dose methotrexate but is not a valid indicator of the number of doses needed for successful resolution.CBC,LFT,KFT is performed before giving methotrexate because of potential side effects - liver involvement, stomatitis, gastroenteritis, bone marrow depression and is excreted mainly by renal mechanism

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