Hospital admission and surgical approach to tubal ectopic pregnancy in Australia 2000 to 2014: A population-based study.

ABSTRACT

BACKGROUND: There are several accepted approaches to management of ectopic pregnancy, both surgical and non-surgical. When a surgical approach is used, there appears to be an equipoise between tubal preservation and removal. We sought to determine the patterns of surgical management of ectopic pregnancy in Australia since the year 2000. MATERIALS AND METHODS: Data regarding hospital admissions for ectopic pregnancy were extracted from the Australian Institute of Health and Welfare national procedural dataset for the years 2000-2013. Surgical procedures were classified as open or laparoscopic, and involving salpingotomy or salpingectomy (tubal removal). The results were stratified into age bands. RESULTS: Over the study period hospital admission rates for ectopic pregnancy rose in women under the age of 30, without an increase in surgical procedures, while the rate of surgical procedures fell in women in older age groups. Rates of management of ectopic pregnancy via laparotomy fell in all age groups, as did rates of tubal preservation. CONCLUSION: Since the year 2000 there have been changes in the management of ectopic pregnancy, with significant reductions in open surgery and tubal preservation.