Single best prognostic indicator of successful treatment with single-dose Methotrexate is: (A) Gestational sac size, (B) Serum b-hCG level, (C) Absence of fetal cardiac activity, (D) Pain abdomen
Answer is B. The best candidate for medical therapy is the woman who is asymptomatic, motivated, and compliant. With medical therapy, some classic predictors of success include a low initial serum b-hCG level, small ectopic pregnancy size, and absent fetal cardiac activity. Of these, initial serum b-hCG level is the single best prognostic indicator of successful treatment with single-dose MTX. Specifically, repoed failure rates are 1.5 percent if the initial serum b-hCG concentration is <1000 mIU/mLReference: William's Obstetrics; 25th edition; Chapter 19; Ectopic pregnancy