Effects of the COVID-19 pandemic on timely care for extrauterine pregnancies: A retrospective analysis

Anteby, Matan; Mil, Liel Van; Michaan, Nadav; Laskov, Ido; Grisaru, Dan

doi:10.1016/j.lanepe.2021.100026

Cited by 9 publications

(13 citation statements)

References 17 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 This has taken a toll on emergent non-COVID-19 related visits to the emergency department and, as such, on non-COVID-19-related deaths. 9 A similar case as above could have been detected at an early gestation in non-COVID era by routine ultrasonographic scan and managed timely medically without any emergency surgical intervention. For patients with COVID-19 and ectopic pregnancy in vitally stable conditions (i.e., no rupture), medical therapy with methotrexate is preferable.…”

Section: Discussionmentioning

confidence: 68%

Challenge in challenging times: a case report of ruptured isthmic ectopic pregnancy in an asymptomatic COVID-19 positive patient

Gahlot

Raval

Yadav

et al. 2021

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Emergency surgical management of patients who are COVID-19 positive is extremely challenging for the treating doctors as there is a need to keep the balance between delivering optimal medical care to the patient, preventing spread to others and protecting ourselves. COVID-19 manifestations in pregnant women are similar to non-pregnant patients. The patient may be asymptomatic or may present with symptoms like cough, cold, fever and shortness of breath. In obstetric emergencies like ruptured ectopic pregnancy, when a patient presents in casualty with history of amenorrhea, pain abdomen and features of shock, main priority for the clinician is to stabilize them and treat the underlying cause so as to save their life. We report the emergency management of a hemodynamically unstable ruptured ectopic pregnancy at 9 weeks of gestation in a COVID-19 positive patient. It was stressful for the treating doctors because of high infectivity of the disease, scarcity of resources during the pandemic and precarious condition of the patient.

show abstract

Section: Discussionmentioning

confidence: 68%

Challenge in challenging times: a case report of ruptured isthmic ectopic pregnancy in an asymptomatic COVID-19 positive patient

Gahlot

Raval

Yadav

et al. 2021

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…Included study characteristics 12 studies, involving a total of 3122 women, were eligible for data extraction (Table 1). Five studies were from Europe (UK and Italy) (3) (21) (22) (23,24), four from America (USA and Canada) Gomez (4) (6) (7) (25) and three from the Middle East (Israel) (2,26), (27) . Nine studies were single centre retrospective studies (2, 3, 6)(10) (22,23,(25)(26)(27), one was a multicentred prospective study (21) and two multicentred retrospective studies (4), (24).…”

Section: Figurementioning

confidence: 99%

“…Outcomes: Surgical versus non-surgical management 10 studies involving 2714 women, reported on the method of management of ectopic pregnancies during Covid compared to a pre-Covid cohort (2,3,6) (21)(22)(23)(24)(25)(26)(27). A total of 719 women underwent surgical management in the pre-Covid cohort versus 551 in the Covid cohort.…”

Section: Figurementioning

confidence: 99%

“…Ruptured ectopic rate 9 studies including 1531 women compared the number of ruptured ectopic pregnancies during Covid to a matched pre-Covid cohort (2,6,(21)(22)(23)(24)(25)(26)(27). Data collected from these studies were analysed to compare the rate of rupture between the two cohorts.…”

Section: Figurementioning

confidence: 99%

“…The risk of ectopic pregnancy (EP) is reported as 1 to 2% of all pregnancies (1).During the COVID-19 Pandemic, in an attempt to prevent overwhelming of healthcare systems and reduce community transmission of the virus, governments advised patients to attend hospital only when absolutely necessary. As a result, some studies reported a significant reduction in presentation to emergency gynaecological services, potentially leading to significant delay in diagnosis (2)(3)(4)(5)(6)(7). EP remains associated with significant morbidity and a maternal mortality rate of 0.2 per 1000 in the UK (8).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

To fight or to flee? -- a systematic review of ectopic pregnancy management during Covid-19.

Morin

Sideris

Platts

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Concerns about virus spread during surgery contributed to changes in the clinical management of ectopic pregnancies (EP) during the COVID19 pandemic. Objective: To compare published data on EP management prior versus during the COVID-19 pandemic and evaluate any difference in the management, rupture rate and complications where Early Pregnancy Unit (EPU) structures exist. Search strategy: We performed a systematic review of the literature using a keyword strategy based on our PICO criteria. Selection criteria: We included studies which recruited women diagnosed with ectopic pregnancy and compared the management during and prior the COVID-19 pandemic peak. Data collection and Analysis: Three independent reviewers screened the literature and extracted the data. Meta-analysis of the data was performed on Revman. Main Results: Our search yielded 34 studies; 12 were included in our meta-analysis (3122 women). We found no difference in the type of management of EP between the pre-Covid and Covid cohorts [2714 women, OR 0.99(0.63-1.55), p=0.96, I2=77%]. We observed a non-statistically significant reduction of surgical management within the EPU branch ([OR 0.47(0.19-1.13), p=0.09, I2=81%]). There was no difference in the ectopic rupture rate in units with EPU [OR= 0.66 (0.33-1.31), p=0.24, I2=37%]. In contrast, in non-EPU (NPEU) the risk of ruptured EP [OR=2.86(1.84-4.46), p<0.01 I2=13%] and complications [OR=1.69(1.23-2.31), p=0.001, I2=45%] were increased. Conclusions: The worldwide trend was not reflected in the UK suggesting that EPU may have contributed to prompt diagnosis and safe management of EP. Funding: No funding was received. Keywords: ectopic pregnancy, COVID 19, meta-analysis, early pregnancy unit

show abstract

Predictors of Mother and Infant Emergency Department Attendance and Admission: A Prospective Observational Study

Mason‐Jones

Beltrán

Keding

et al. 2023

Matern Child Health J

View full text Add to dashboard Cite

Objective To explore the predictors of emergency department attendance and admission for mothers and their infants. Methods Self-reported emergency department (ED) attendance and admission, sociodemographic, mental health, and other measures were recorded at baseline and at 12 months at 4 sites in England between May 2017 and March 2020. Results Infants’ gestational age (OR 0.73, 95% CI 0.61 to 0.88, p = 0.001), mothers’ mental health (OR 2.40, 95% CI 1.30 to 4.41, p = 0.005) and mothers’ attendance at ED (OR 2.34, 95% CI 1.13 to 4.84, p = 0.022) predicted infant ED attendance. Frequency of attendance was predicted by ED site (IRR 0.46, 95% CI 0.29 to 0.73, p = 0.001) and mothers’ age (IRR 0.96, 95% CI 0.92 to 1.00, p = 0.028). Infant hospital admissions were predominantly for respiratory (40%) and other infectious diseases (21%) and were predicted by previous health problems (OR 3.25, 95% CI 1.76 to 6.01, p < 0.001). Mothers’ ED attendance was predicted by mixed or multiple ethnic origin (OR 9.62, 95% CI 2.19 to 42.27, p = 0.003), having a male infant (OR 2.08, 95% CI 1.03 to 4.20, p = 0.042), and previous hospitalisation (OR 4.15, 95% CI 1.81 to 9.56, p = 0.001). Hospital admission was largely for reproductive health issues (61%) with frequency predicted by having attended the ED at least once (IRR 3.39, 95% CI 1.66 to 6.93, p = 0.001), and being anxious or depressed (IRR 3.10, 95% CI 1.14 to 8.45, p = 0.027). Conclusions for Practice Improving the reproductive and mental health of mothers may help to avoid poor maternal and infant health outcomes and reduce emergency service utilisation and hospitalisation.

show abstract

Effects of the COVID-19 pandemic on timely care for extrauterine pregnancies: A retrospective analysis

Cited by 9 publications

References 17 publications

Challenge in challenging times: a case report of ruptured isthmic ectopic pregnancy in an asymptomatic COVID-19 positive patient

Challenge in challenging times: a case report of ruptured isthmic ectopic pregnancy in an asymptomatic COVID-19 positive patient

To fight or to flee? -- a systematic review of ectopic pregnancy management during Covid-19.

Predictors of Mother and Infant Emergency Department Attendance and Admission: A Prospective Observational Study

Contact Info

Product

Resources

About