Relationship of high pretreatment folic acid level and failure of methotrexate in ectopic pregnancy: A pilot study

Peter Takacs, Leandro Rodriguez, Vanessa Laibl, Paul Pietro, Julie Kang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE: To test the hypothesis that high (≥20.7 ng/mL) pretreatment serum folic acid level increases the failure of single-dose methotrexatefor ectopic pregnancy. STUDY DESIGN: Twenty patients with ectopic pregnancy and measured pretreatment folic acid levels were divided into 2 groups based on pretreatment serum folk acid level (< or ≥20.7 ng/mL). All patients were candidates for single-dose methotrexate treatment. Variables analyzed in the 2 groups were pretreatment folic acid level, initial β-human chorionic gonadotropin (hCG) level, size of the ectopic mass, presence of fetal heart tones and clinical outcomes. RESULTS: Eleven patients had serum folic acid levels < and 9≥20.7 ng/mL. The mean (±SD) folic acid level was 13.4 ng/mL (±3.2) in the group with folic acid levels <20.7 ng/mL, significantly lower than in the group with folic acid levels >20.7 ng/mL (p<0.001). The 2 groups were similar in initial hCG level, size of the ectopic mass and presence of fetal heart tones. The failure rate was significantly higher in the group with pretreatment serum folic acid levels ≥ 20.7 ng/mL as compared to the group below (n = 4, 44%, vs. n = 0, 0%; p = 0.02). CONCLUSION: High pretreatment folic acid levels increase the risk of treatment failure with single-dose methotrexate.

Original languageEnglish (US)
Pages (from-to)713-716
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume49
Issue number9
StatePublished - Sep 2004

Fingerprint

Ectopic Pregnancy
Folic Acid
Methotrexate
Serum
Fetal Heart
Treatment Failure
Acids

Keywords

  • Ectopic
  • Folic acid
  • Methotrexate
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Relationship of high pretreatment folic acid level and failure of methotrexate in ectopic pregnancy : A pilot study. / Takacs, Peter; Rodriguez, Leandro; Laibl, Vanessa; Pietro, Paul; Kang, Julie.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 49, No. 9, 09.2004, p. 713-716.

Research output: Contribution to journalArticle

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AU - Pietro, Paul

AU - Kang, Julie

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AB - OBJECTIVE: To test the hypothesis that high (≥20.7 ng/mL) pretreatment serum folic acid level increases the failure of single-dose methotrexatefor ectopic pregnancy. STUDY DESIGN: Twenty patients with ectopic pregnancy and measured pretreatment folic acid levels were divided into 2 groups based on pretreatment serum folk acid level (< or ≥20.7 ng/mL). All patients were candidates for single-dose methotrexate treatment. Variables analyzed in the 2 groups were pretreatment folic acid level, initial β-human chorionic gonadotropin (hCG) level, size of the ectopic mass, presence of fetal heart tones and clinical outcomes. RESULTS: Eleven patients had serum folic acid levels < and 9≥20.7 ng/mL. The mean (±SD) folic acid level was 13.4 ng/mL (±3.2) in the group with folic acid levels <20.7 ng/mL, significantly lower than in the group with folic acid levels >20.7 ng/mL (p<0.001). The 2 groups were similar in initial hCG level, size of the ectopic mass and presence of fetal heart tones. The failure rate was significantly higher in the group with pretreatment serum folic acid levels ≥ 20.7 ng/mL as compared to the group below (n = 4, 44%, vs. n = 0, 0%; p = 0.02). CONCLUSION: High pretreatment folic acid levels increase the risk of treatment failure with single-dose methotrexate.

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