ROLE OF DAY 4 AND DAY 7 Β-HCG AS AN EARLY PREDICTOR OF SUCCESS AFTER METHOTREXATE THERAPY FOR TUBAL ECTOPIC PREGNANCIES

Background: Tubal ectopic pregnancy is potentially life-threatening with an estimated incidence of 1% to 2% all pregnancies the wide availability transvaginal ultrasound and quantitative serum beta human chorionic gonadotropin (β-hCG) assay; can be diagnosed early, leading successful management without resort surgery. Objective: Evaluation β-hCG levels between days 4 7 as a predictor methotrexate therapy success for pregnancy. Patients Methods: 50 cases, pregnancy, This study was carried out on Al-Hussein Hospital during July 2018 August 2019 All cases were subjected full history taking, complete clinical examination, ultrasongraphy Laboratory investigations Complete blood count, Liver profile (ALT AST), Serum creatinine, day1, 4, and7 after therapy. Results: The mean age 28 ± 5 years, ranging 20 40 years. average gestational weeks, while parity 1. Of 36 patients (72%) succeeded 14 failed. ROC curve hCG index identified value 0.192 (19% decrease day 1 4) best treated successfully single dose methotrexate. Sensitivity test 80% accuracy 75%. Conclusion: Early decline associated very high probability treatment success. However, given that we found rate, not 100%, suggest it prudent continue serial monitoring until resolution