Role of various complete blood count parameters in predicting the success of single-dose Methotrexate in treating ectopic pregnancy

Objective: The protocol of 15% BhCG decrease between Days four and seven is frequently used for evaluating the success of methotrexate administration in treating ectopic pregnancy. Our objective was to study the usage of hematologic parameters for evaluating the success of methotrexate administration in treating ectopic pregnancy.

Method: This study was conducted between February 2014 and December 2016. Data of 434 patients were retrospectively scanned for the study. One hundred sixty-one patients whose Day one, four and seven results were recorded in the hospital information system and who were followed up until their BhCG levels decreased <10 IU/L were enrolled in the study. Three types of complete blood cell count parameters of the patients were used: 1) Neutrophil-to-lymphocyte ratio (NLR). 2) Platelet distribution width (PDW), 3) Platelet count (PLT).

Results: Patients were separated into two groups as those who were treated with single-dose methotrexate and those who required surgical treatment. A significant difference was detected between the groups in terms of NLR levels on Days 1, 4, and 7 (p=0.012, p=0.035, and p=0.001, respectively). There was no significant difference detected between the groups for PDW and PLT counts on Days one, four and seven.

Conclusions: NLR can also be used as an alternative to BhCG for evaluating the success of single-dose methotrexate administration in treating ectopic pregnancy. However, there is need for further studies on this topic.