Ectopic pregnancy hospitalisations: A national population-based study of rates, management and outcomes

Objective: To determine whether there were changes in the incidence, management and outcomes of ectopic pregnancy hospitalisations in Ireland during 2005–2016. Study design: Population-based study was carried out from January 2005 to December 2016. A total of 12,098 women hospitalised due to ectopic pregnancy. All acute maternity hospital settings in the Republic of Ireland. Electronic health records were retrieved using the Hospital In-Patient Enquiry database. Rates ratios were calculated to estimate trends, risk of blood transfusion and risk of extended stay at the hospital. Results: The rate of hospitalisation for ectopic pregnancy increased over the 12-year study period from 12.8/1,000 deliveries in 2005 to 17.7/1,000 deliveries in 2016. Risk of blood transfusion reduced over time (aIRR 0.8; 95%CI 0.6–0.9). Women aged at least 40 years had double the risk of hospitalisation and double the risk of blood transfusion. Women undergoing open surgical procedures were more likely to need a blood transfusion than those undergoing laparoscopic salpingectomy. Similar results were found for length of stay over two days. Blood transfusion was rare for patients who underwent medical management (aIRR 0.1; 95%CI 0.05–0.2). Conclusion: Advanced maternal age increased risk of hospitalisation for ectopic pregnancy. While the overall rate of hospitalisations increased over time, there was a reduction in the risk of blood transfusion and length of stay over two days. Type of management significantly affected the risk of blood transfusion and length of stay over two days at the hospital.