Successful Management of Ectopic Pregnancy Using a Single-Dose Inj Methotrexate Regimen in a Private Healthcare Setting

Background: Ectopic pregnancy is a major cause of maternal mortality and morbidity for mothers in the first trimester. Single-dose Inj methotrexate therapy, administered at 1 mg/kg of body weight, is a successful non-surgical treatment for stable patients with unruptured ectopic pregnancies. This study aimed to evaluate the outcomes of single-dose Inj methotrexate treatment in managing unruptured ectopic pregnancies in a private healthcare setting. Methods: This study looked back at 100 patients who received single-dose Inj methotrexate (1.0 mg/kg) as the first treatment for ectopic pregnancy at Salauddin Specialized Hospital from January 2022 to January 2023. The patients included in the study were stable women with confirmed ectopic pregnancies based on transvaginal ultrasound and β-hCG levels. SPSS v26 was utilized for the statistical analysis and identified predictors via chi-square tests and multivariate logistic regression (p<0.05). Results: Single-dose Inj methotrexate had an 80% success rate. 35% of patients were between 25 and 35 years old, which is the highest range, and the majority had tubal ectopic pregnancies (80%). Successful outcomes were strongly associated with β-hCG levels between 1000-3000 mIU/mL (AOR 2.35, 95% CI: 1.02-5.41, p = 0.045), and smaller ectopic mass size (2.5–4.0 cm) (AOR 2.28, 95% CI: 1.01-5.17, p = 0.049) were independently associated with higher odds of treatment success with single-dose methotrexate, while gravidity and ectopic site showed no significant association. Conclusion: Single-dose Inj methotrexate is highly effective for properly chosen patients with ectopic pregnancy. Lower β-hCG levels and smaller mass sizes are important indicators of treatment success. This highlights the need for early diagnosis and careful patient selection.