Methotrexate Success Varies in Ectopic Pregnancy Types
Overall success rates for intramuscular (IM) methotrexate were comparable between recurrent and primary ectopic pregnancy cases, but single-dose treatment was less effective in recurrent cases. Analysis of 3944 patients revealed that multidose regimens achieved similar success rates in both groups, suggesting a potential benefit of routine multidose treatment for recurrent cases.
METHODOLOGY:
Researchers conducted systematic searches of MEDLINE, EMBASE, and Scopus databases through February 2025, following PRISMA guidelines for meta-analysis.
Analysis included 3944 patients (502 with recurrent and 3442 with primary ectopic pregnancy) from 15 observational studies, with patients aged ≥ 18 years receiving IM methotrexate treatment.
The primary outcome measure was treatment success, defined as complete resolution of ectopic pregnancy without requiring further intervention.
TAKEAWAY:
Single-dose IM methotrexate had lower success rates in patients with recurrent ectopic pregnancy than in those with a primary ectopic pregnancy (relative risk [RR], 0.79; 95% CI, 0.63-1.00; P = .050).
Multidose IM methotrexate treatment showed no significant difference in success rates between recurrent and primary ectopic pregnancy groups (RR, 1.14; 95% CI, 0.71-1.84; P = .590).
Substantial heterogeneity was observed among studies analyzing single-dose (I² = 73.0%) and multidose (I² = 64.0%) treatment outcomes.
IN PRACTICE:
'Current observational data suggest that patients with recurrent ectopic pregnancy should be considered for multidose IM methotrexate to achieve similar rates of success compared with primary ectopic pregnancy,' wrote the authors of the study.
SOURCE:
The study was led by Shreya Bhat, MBChB, PGDipOMG, Department of Obstetrics and Gynaecology, Palmerston North Hospital, Te Whatu Ora MidCentral in Palmerston North, Aotearoa New Zealand. It was published online in Obstetrics & Gynecology.
LIMITATIONS:
According to the authors, substantial heterogeneity in outcome definitions and baseline cohort characteristics between studies affected the analysis. Most studies were retrospective cohort designs, introducing potential selection bias and confounding factors. The researchers noted that over 50% of studies failed to identify relevant confounding variables, which likely contributed to the large observed CIs for effect estimates.
DISCLOSURES:
The authors did not report any potential conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Forbes
6 minutes ago
- Forbes
Your Attention Is Being Sold: 4 Strategies To Protect It
New data underscores the booming business of attention—with advertising spend outpacing consumer ... More spend. Feeling increasingly distracted? New data suggests it's not in your head. According to PwC, global entertainment and media revenues are projected to reach $3.5 trillion by 2029. What's fueling growth? Buying and selling attention. The report highlights that advertising spend is projected to grow three times faster than consumer spend (6.1% vs 2% CAGR). When companies are willing to pay a cost per click, the world is designed to distract - and that design is profitable. Distraction isn't a personal flaw. In 2025, when attention is more commoditized than ever, the smarter move is to prepare for distraction—and sharpen strategies for when it inevitably happens. Attention: Profitable for Companies. Costly for Consumers. Consumer focus is incredibly valuable - to companies. Just as an example, Meta's 2025 revenue, over $164 billion across Facebook, Instagram, WhatsApp and more, comes largely from ads. But what these platforms really monetize is time and attention. As a result, if attention is profitable for companies, it is costly for people in ways that add up: Lost Productivity: Research aggregated by UC Berkeley shows it can take between 8 and 23 minutes to return to deep focus after an interruption. What does this mean? Getting distracted three times in a day, even if briefly, could mean an hour of overall lost productivity. Mental Health: Studies link frequent phone connection to poor sleep quality and higher stress. Addiction: Reports suggest that it can take just 30–35 minutes of scrolling on TikTok to trigger addictive patterns. As Dr. Thekla Brumder Ross, clinical psychologist, addiction and well-being expert, shared in a Zoom interview, 'The average American spends 12 hours a day on a screen… it's rewiring our dopamine reinforcement loops. And there is no current criteria in the DSM-5 for general technology addiction." Decreased Joy: Time away from phones, especially in motion, has been tied to higher life satisfaction. Small pockets of disconnection matter. Attention Management: Four Strategies to Sharpen Focus What can you do? One tactic is simply disabling alerts; a 2025 Reuters analysis found 43% of respondents turned off news notifications. However, in work and life total disconnection is rarely possible and platforms will continue innovating ways to pursue attention. Better than unplugging is a plan: build a deliberate playbook to manage connection and handle distraction. Here are four strategies to do exactly that: At least once a day take a 5-10 minute phone-free walk. Use the time for social connection or simply enjoy your own thoughts, not someone else's. Try this: When you go get coffee, swing by a coworker's desk, or step outside, leave the phone behind at least once next week. Use your phone to help manage your focus. Try This: Go beyond 'Do Not Disturb' by programming focus modes by day, time and app for different work and life scenarios. For example, if you prioritize deep work from 8:00 a.m. to 10:00 a.m. on Wednesdays but still need to be reachable for family or a key client, you can program a mode that allows only those calls and blocks social apps. As new scenarios arise, take 30 seconds to create a focus mode for it so you are ready next time. Brumder Ross recommends a strategy called 'Release the Grip' to promote intentional phone use. Try This: Instead of grabbing your device, place your palm gently on top of it, turn it face up and ask, 'What do I need in this moment?' This is a self-compassion check. Maybe you need to knock out a few transactional tasks. Maybe you don't. Maybe you simply need to write a note and handle it later. The question interrupts the impulse to scroll and clarifies intent. Every notification creates an opening. First Slack, then LinkedIn, then the pull to check one more thing. Instagram. Being reachable isn't just about responsiveness. It's about attention - and how easily it gets redirected. As a result, managing distraction means managing expectations. 'No one is going to communicate your boundaries for you. You have to do that,' Brumder Ross says. Try This: Clarify when you're reachable and how. Use tools people actually check: calendar blocks, Slack statuses or away messages like 'Heads down until 2:00 p.m., back after.' However, setting the boundary isn't enough - you have to enforce it. If you respond during focus time, you're signaling that you're available. Particularly for anyone leading a team or managing others, modeling how you manage your focus offers permission for others to do the same. Companies Have a Strategy for Your Attention. Create Your Own. The attention economy is only getting louder. However, as Brumder Ross highlights, 'You can't control what the tech companies do, but you can control where you put your attention." The news cycle will not slow. Work will not pause. Connection is part of modern life. However, you may not have to fight the current or disengage completely. The key takeaway is to simply have strategies for managing distraction and engaging with technology on your terms. Reclaiming focus isn't about perfection. It's about practice - and power.
Washington Post
2 hours ago
- Washington Post
Scientists discover less invasive way to collect babies' stem cells
Researchers have come up with a less invasive way to collect amniotic stem cells — a development they say could reduce dangers for pregnant women and other pregnant individuals as well as fetuses and help researchers grow cells that can help children born with congenital conditions. Scientists use amniotic stem cells to treat congenital anomalies such as spina bifida and heart defects.
Yahoo
3 hours ago
- Yahoo
Hot vs cold: which is better for muscle recovery? New study says this is the answer
When you buy through links on our articles, Future and its syndication partners may earn a commission. We're hardly short on ways to boost muscle recovery, whether it's pummeling ourselves with the best massage guns or paying a visit to the local physiotherapist. But a debate has been simmering in the background about hot and cold therapy, and it's this: is heat or ice better for muscle recovery? Or both? Growing up, I've always been taught to apply ice to swollen ankles or sore muscles post-workout, but then the rise of heat therapy came along, and suddenly, you're either jumping into an ice bath, braving an infrared sauna, or flipping between the two in something called 'Contrast Water Therapy.' Now, a study says this is the real answer. Here's what it shows. What is the study? A study published in the Journal of Physiology looked at the effects of hot water and cold water therapy on muscle recovery in 34 participants. They found evidence to suggest that hot water immersion therapy significantly improved recovery compared to cold water. They found evidence to suggest that hot water immersion therapy significantly improved recovery compared to cold water. Researchers simulated a muscle injury in a lab setting, then used several modalities to see which would offer the most improvement. Participants were offered three recovery methods: cold (15 minutes at 12 degrees Celsius / 53.6 Fahrenheit), hot (60 minutes at 42 degrees Celsius / 107.6 Fahrenheit) and room temperature (30 minutes at 12 degrees Celsius / 53.6 Fahrenheit), all performed daily for 10 days. Recovery was monitored using inflammation markers, muscle biopsies and performance testing. While strength improvements were similar in each setting, hot water showed to reduce perceived muscle pain and improve muscle damage markers; cold water didn't improve perceived muscle pain or reduce markers of damage. In short, the experiment found that hot water immersion could be more beneficial than cold water and room temperature immersion recovery methods for muscle regeneration and injury. Benefits of cold water immersion Whether it's wild swimming, cryotherapy, or ice plunges, subjecting the body to temperatures below 15 degrees Celsius (59 degrees Fahrenheit) has been thought to have multiple benefits for the body, including boosting mood and focus and enhancing recovery. One study published in Biology reported participants felt more alert and attentive and less nervous or distressed after cold water bathing. The American Heart Association (AHA) warns of some risks associated with cold water immersion, and the data surrounding the practice is limited, so always exercise this form of recovery with caution and seek medical advice if you're unsure. Benefits of hot water immersion There are many types of heat therapy, such as infrared saunas, traditional saunas, steam rooms and heat packs. However, it's hot water immersion — think hot tubs or similar — that could be the most effective. A study found that soaking in a hot tub, or soaking in hot water in general, could boost blood flow, immune response and cardiovascular health compared with traditional or infrared saunas when assessing heat methods. This could be in part because the immersion method helps raise core body temperature more effectively, which could be a key stimulus for the responses the study found. Then, there's contrast therapy, or hot and cold therapy (as it's also known). This involves switching between both methods in the same recovery session, allowing you to benefit from the energizing and mood-boosting benefits of cold water, followed by the soothing and relaxing benefits of heat. Here's a little evidence to support the method: a study published in PLoS One found that contrast therapy outperformed passive recovery or rest in reducing muscle pain after workouts in athletes. The next time you're faced with the decision: Hot or cold? Now you know which way to swing. Follow Tom's Guide on Google News to get our up-to-date news, how-tos, and reviews in your feeds. Make sure to click the Follow button. More from Tom's Guide Forget running and swimming — study finds this sport adds 10 years to your life Forget running — new study shows this exercise can burn body fat as much as cardio Forget 10,000 steps — study reveals the real number of minimum daily steps you should take, according to your age
