Impact of severe acute respiratory syndrome coronavirus 2 on ectopic pregnancy management in the United Kingdom: a multicentre observational study. Platts S et al, Impact of severe acute respiratory syndrome coronavirus 2 on ectopic pregnancy management in the United Kingdom: a multicentre observational study, BJOG an International Journal of Obstetrics and Gynaecology. May 3, 2021.

I chose to present this article in conjunction with my case presentation of a 38-year female with left tubal ectopic pregnancy. This article discussed the impact of Covid-19 on the management of women with ectopic pregnancy.

It was a multicentre prospective cohort observational study, it compared outcomes of women with ectopic pregnancy during the pandemic to the pre-pandemic cohort. Five London University hospitals were included. The pandemic group were patients entered into the database between March 2020 and August 2020 and the prepandemic group included patients from January 2019 to June 2019.

The main outcomes studied were: patient demographics, management of the ectopic pregnancy, length of treatment, number of hospital visits for non surgical management, length of stay for surgical management and complication at 30 days. 341 women were included, 162 in the pandemic group and 179 in the pre-pandemic group. Significantly lower amounts of women underwent surgical management in the pandemic group (58.6% vs 72.6%). Patients managed expectantly in the pandemic group had fewer mean number of hospital visits (three vs. nine), patients managed medically the pandemic group had significantly lower numbers of hospital visits (six vs. nine). There was no observed difference in complication rates between the two cohorts.

The authors concluded that women during the pandemic were managed with significantly higher rates of non-surgical  management and had fewer hospital visits, however this was not associated with an increased complication rates. Strengths of this study include that it is a multicentre study. Weaknesses include patients in the cohorts being from the same centers but were not matched, patient and clinician decision making process regarding the choice of management was not reviewed in this study.

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