A patient treated with single-dose methotrexate for ectopic pregnancy at day 0 (day-1 dose) has βhCG of 3200 mIU/mL on day 1 and 3800 mIU/mL on day 4. This finding indicates:

• A Treatment failure requiring immediate surgery
• B Indication for second dose of methotrexate now
• C Resolution of ectopic pregnancy
• D Expected post-treatment hCG rise; repeat level on day 7 ✓

Explanation

After single-dose methotrexate for ectopic pregnancy, βhCG levels typically rise or plateau between days 1 and 4 before beginning to fall. This initial rise is expected and does not indicate treatment failure. The critical measurement is on day 7; a decline of ≥15% from day 4 to day 7 indicates successful treatment. Surgical intervention or second-dose decisions are made based on the day 7 result.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.