Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
164 Doctors are Online

On methotrexate, took injection for ectopic pregnancy treatment, tests do not show change in hcg levels, have occasional spotting. Advise?

Hello. I am currently on methotrexate to treat an ectopic pregnancy . I had the injection Friday, at which point my hcg was around 2400. I had my labs checked again today, and the obgyn RN called me to tell Memy levels have stayed the same. However, I understand it s really the second hcg test that will tell if treatment worked. I m concerned that there was no change at allot my levels, I have left sided mild aching and the occasional blood clot, light spotting. Any recommendations or reassurance? I called my clinic back, but did not receive a call back.
Asked On : Fri, 14 Sep 2012
Answers:  1 Views:  59
Report Abuse
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Medical Topics
OBGYN 's  Response
Hi and welcome,

There are different protocols that are used. A decline in the value between day 0 and 4 predicts that the treatment will be more likely successful with a single dose.
Generally a serum HCG on day 4 after therapy is compared with day 7. If the decrease from day 4 value is more than 15% nothing is done. If it is less, a second dose of methotrexate may be given. The size of the sac and presence of fetal heart beat in any would have helped in providing a better opinion.

However the patient needs close monitoring during the entire period. In my clinic, I prefer in hospital management and do not send my patient home. A pulse and BP record as well as symptom record is kept so that if there is a rupture she may be operated easily.

If at any time you find that you are having increase in pain, palpitations [ awareness of heart beat] giddiness, difficulty in breathing, please rush to the ER.

The spotting happens sometimes in ectopic as the uterine lining is shed off.

If you do not have any new symptoms, it is OK just wait for second test.
Thanks for using HCM and take care.

Dr Nilajkumar Bagde
Consultant Obstetrician and Gynecologist
Answered: Sat, 22 Mar 2014
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]


Loading Online Doctors....
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor