Population-Based Ectopic Pregnancy Trends, 1993–2007

Abstract

Background The accuracy of ectopic pregnancy rates based on nationally representative data has been compromised for many years, impairing surveillance and evaluation of the continued public health importance of this condition. Purpose To estimate long-term population-based ectopic pregnancy rates and trends within a defined population over a largely unevaluated time period, including the evaluation of trends in outpatient versus inpatient management and medical versus surgical treatment modalities. Methods Using computerized Group Health Cooperative inpatient and outpatient data, age-adjusted and age-specific ectopic pregnancy rates were calculated from 1993 to 2007 among enrollees aged 15–44 years. Overall trends and trends for care setting (inpatient versus outpatient) and treatment modality (medical versus surgical) were also evaluated. Analyses were conducted in 2009. Results Between 1993 and 2007, 2114 ectopic pregnancy cases (726 inpatient; 1388 outpatient) were identified among 1 180 070 woman-years, an annual age-adjusted ectopic pregnancy rate of 17.9 per 10 000 woman-years. Rates were stable from 1993 to 2004 and increased in the most recent 3 years (2005–2007, rate = 21.1 per 10 000 woman-years). Rates per 1000 pregnancies increased over the 15-year period from 19.2 to 26.2 per 1000 pregnancies (p-value = 0.001). Inpatient-diagnosed cases decreased from 45.4% in 1993–1995 to 26.9% in 2005–2007 (p-value < 0.0001) and the percentage with surgical treatment decreased from 48.1% to 30.7% (p-value < 0.0001). Conclusions The results suggest a trend toward increasing ectopic pregnancy rates over a recent 15-year period. Rates are similar to the last available national estimate suggesting that the significance of ectopic pregnancy as a public health problem has not diminished in these intervening years.

Feasibility of laparoscopy in management of ectopic pregnancy: experience from a tertiary care hospital

“…Proportion of patients managed surgically in our study was higher than that mentioned by other studies where surgical management rate was around 30-40%. 2,13 It was similar to that reported by de Bennetot M et al 14 Reason being almost two third of our patients had ruptured ectopic at presentation and most of the unruptured ectopic patients presented late to us, were not suitable candidates for medical management.…”

“…1 There has been an increasing trend in the incidence of such pregnancies from 19.2 to 26.2 per 1000 pregnancies. 2 But the case fatality rate has gone down due to early diagnosis and timely intervention. 3,4 It is still high in developing world.…”

Association of anti-Chlamydia antibodies with ectopic pregnancy in Benin city, Nigeria: A case-control study

“…This view is sustained by its rising incidence globally [3][4][5][6][7] . Recent work from Benin City, Nigeria suggests that the trend in ectopic pregnancy incidence was that of a yearly rise 1 .…”

The Association between &lt;i&gt;Chlamydia Trachomatis&lt;/i&gt; and Ectopic Pregnancy in Lagos, Nigeria—A Case Control Study

“…Ectopic pregnancy remains a major public health problem and its incidence has been increasing all over the world in recent times [3]- [6]. Approximately 1% -2% of all pregnancies in Europe and the USA are ectopic and in the Western world, tubal ectopic pregnancy remains the most common cause of maternal mortality in the first trimester of pregnancy [7] [8].…”