Determining treatment success in tubal ectopic pregnancies – the predictive value of the delta neutrophil index in single-dose methotrexate therapy

• Authors: Busra Korpe , Caner Kose , Gokce Naz Kucukbas , Sevki Celen , Yaprak Engin Ustun

Abstracts

EN

Introduction and aim. This study assessed the significance of the Delta neutrophil index (DNI) in predicting the effectiveness of single-dose methotrexate (MTX) treatment for tubal ectopic pregnancy. Material and methods. In this retrospective study, 214 women diagnosed with tubal ectopic pregnancies and treated with MTX between 2019 and 2022 were included. Group 1 comprised 88 MTX responders, while group 2 consisted of 86 non-responders necessitating surgery. HCG and DNI levels were monitored on day 1, 4, and 7 of MTX treatment and compared between the groups. Results. Group 1 exhibited significantly lower HCG and DNI levels compared to group 2 on days 1, 4, and 7 (p<0.001). Both HCG and DNI levels on days 1 and 4 of MTX treatment were significant predictors of treatment failure, with the highest AUC observed for DNI was on day 4. In multivariate logistic regression analysis, elevated DNI levels on day 1 of MTX treatment were associated with a 5.8-fold increased risk, and DNI levels on day 4 were associated with a 4.44-fold increased risk of MTX treatment failure. Conclusion. DNI emerges as a valuable marker for predicting the success of single-dose methotrexate treatment in tubal ectopic pregnancies, demonstrating superior predictive power compared to HCG.

Keywords

EN

clinical prediction; ectopic pregnancy outcomes; methotrexate efficacy; neutrophil response; prognostic indication

• Publisher: Uniwersytet Rzeszowski. Wydawnictwo Uniwersytetu Rzeszowskiego
• Journal: European Journal of Clinical and Experimental Medicine
• Year: 2024
• Issue: 4
• Pages: 722-728

Dates

published

2024

Contributors

author

Busra Korpe

• Department of Gynecology and Obstetrics, Ankara Etlik City Hospital, Ankara, Türkiye

• https://orcid.org/0000000243155518

author

Caner Kose

• Department of Gynecology and Obstetrics, Ankara Etlik City Hospital, Ankara, Türkiye

• https://orcid.org/0000000230444804

author

Gokce Naz Kucukbas

• Department of Perinatology, Kocaeli City Hospital, Kocaeli, Türkiye

• https://orcid.org/0000000227553700

author

Sevki Celen

• Department of Perinatology, Ankara Etlik City Hospital, Ankara, Türkiye

• https://orcid.org/0000000170333474

author

Yaprak Engin Ustun

• Women’s Health Training and Research Hospital, University of Health Sciences Etlik Zubeyde Hanım, Ankara, Türkiye

• https://orcid.org/0000000210113848

Identifiers

DOI

10.15584/ejcem.2024.4.5

Biblioteka Nauki

62587109