Abstract

Ectopic pregnancy is where a pregnancy develops in an abnormal location, usually within the fallopian tubes. If untreated it can cause a woman to get seriously unwell. Ectopic pregnancy is the leading cause of death worldwide in the first trimester of pregnancy. We examined the diagnosis and management of tubal ectopic pregnancy in a large maternity hospital. We reviewed the records of 451 people treated for tubal ectopic pregnancy from 2017 to 2022. Management was initially managed conservatively (22%), medically (25%) and surgically (53%). Surgery was performed in 63% of cases. Most surgeries were performed in a co-located general hospital theatre (89%), with 54% undertaken outside of normal daytime working hours. Emergency surgery was required in 22% of cases. Only 12% of those managed surgically experienced serious complications, with blood transfusion and high dependency unit admission the most common. A small proportion (10%) of individuals were provided with pregnancy loss information (including resources and support services available), highlighting the importance of recognising ectopic pregnancy as a pregnancy loss and not just a gynaecological emergency. In summary, most tubal ectopic pregnancies were surgically managed, but this was outside normal working hours and in a co-located general hospital. Management of tubal ectopic pregnancy was safe with minimal adverse outcomes.