Increase rate of ruptured tubal ectopic pregnancy during the COVID-19 pandemic.
Abdominal Pain
/ physiopathology
Abortifacient Agents, Nonsteroidal
/ therapeutic use
Adult
COVID-19
Chorionic Gonadotropin, beta Subunit, Human
/ blood
Cohort Studies
Delayed Diagnosis
Female
Humans
Israel
/ epidemiology
Laparoscopy
Methotrexate
/ therapeutic use
Pregnancy
Pregnancy, Tubal
/ diagnosis
Reproductive Techniques, Assisted
Retrospective Studies
Rupture, Spontaneous
/ epidemiology
SARS-CoV-2
Salpingectomy
Ultrasonography, Prenatal
Uterine Hemorrhage
/ physiopathology
COVID 19
Ectopic pregnancy
Lockdown
Methotrexate
Pandemic
Journal
European journal of obstetrics, gynecology, and reproductive biology
ISSN: 1872-7654
Titre abrégé: Eur J Obstet Gynecol Reprod Biol
Pays: Ireland
ID NLM: 0375672
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
15
10
2020
revised:
18
01
2021
accepted:
27
01
2021
pubmed:
27
2
2021
medline:
26
3
2021
entrez:
26
2
2021
Statut:
ppublish
Résumé
During the 2020 COVID-19 pandemic there was a decrease in emergency room arrivals. There is limited evidence about the effect of this change in behavior on women's health. We aimed to evaluate the impact of the COVID-19 pandemic on the diagnosis, treatment and complications of women presenting with a tubal Ectopic Pregnancy (EP). This is a single centre retrospective cohort study. We compared the clinical presentation, treatment modalities and complications of all women presenting in our institution with a tubal EP during the COVID-19 pandemic between 15 March and 15 June 2020, with women who were treated in our institution with the same diagnosis in the corresponding period for the years 2018-2019. The study group included 19 cases of EP (N = 19) that were treated between the 15 March 2020 and 15 June 2020. The control group included 30 cases of EP (N = 30) that were admitted to in the corresponding period during 2018 and 2019. Maternal age, parity, gravity and mode of conception (natural vs. assisted) were similar between the two groups. There was no difference in the mean gestational age (GA) according to the last menstrual period. In the study group more women presented with sonographic evaluation of high fluid volume in the abdomen than in the control group (53 % vs 17 %, P value 0.01). This finding is correlated with a more advanced disease status. In the study group there was a highly statistically significant 3-fold increase in rupture among cases (P < 0.005) and a 4-fold larger volume of blood in the entrance to the abdomen (P < 0.002). We found that there were no cases of ruptured EP in the group of women who were pregnant after assisted reproduction. We found a higher rate of ruptured ectopic pregnancies in our institution during the COVID-19 pandemic. Health care providers should be alerted to this collateral damage in the non-infected population during the COVID-19 pandemic.
Identifiants
pubmed: 33636621
pii: S0301-2115(21)00068-3
doi: 10.1016/j.ejogrb.2021.01.054
pmc: PMC7968738
pii:
doi:
Substances chimiques
Abortifacient Agents, Nonsteroidal
0
Chorionic Gonadotropin, beta Subunit, Human
0
Methotrexate
YL5FZ2Y5U1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
95-99Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
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