Outcomes after ectopic pregnancy ‘broadly reassuring’

By Piriya Mahendra

Women with an initial ectopic pregnancy are no more likely to experience complications in a subsequent pregnancy than are first-time mothers, research shows.

This is in spite of a high chance of a repeat ectopic pregnancy, say Sohinee Bhattacharya (University of Aberdeen, Scotland, UK) and team in PLoS Medicine.

Although women with an initial ectopic pregnancy had an approximate twofold higher chance of another pregnancy within 2 years and after 6 years than women who experienced a live birth and those who experienced a termination, they were significantly less likely to have a second pregnancy than women who experienced an initial miscarriage.

Compared with women who experienced initial live birth, miscarriage, and termination, women with an ectopic pregnancy were at a greater risk for experiencing another ectopic pregnancy, at hazard ratios of 13.0, 6.07, and 12.84, respectively.

However, women who fell pregnant after experiencing an ectopic pregnancy were no more likely to undergo perinatal complications including placenta previa, preeclampsia, placental abruption, preterm delivery, and low birthweight, than women with primigravida or those with a previous miscarriage or termination.

"The results of this study will help clinicians to counsel women with ectopic pregnancy - both at the time of initial diagnosis and treatment, as well as later when they attend for antenatal care," commented Sohinee Bhattacharya (University of Aberdeen, Scotland, UK) and team in a press statement.

They linked Scottish national data on all women whose first pregnancy occurred between 1981 and 2000 to records of a subsequent pregnancy.

A total of 2969 women had an initial ectopic pregnancy, 667,299 had a live birth, 39,705 miscarried, and 78,697 terminated their first pregnancies.

The authors say: "The reduced chance of a pregnancy and increased risk of a second ectopic following ectopic pregnancy indicates the need for a fertility follow-up in women who are keen to conceive."

The fertility follow up would include preconception care, advice to seek expert consultation should the woman wish to start a family, and consideration of an early pregnancy scan to confirm an intrauterine gestation, they explain.

"Overall, the results from this study are broadly reassuring in establishing that obstetric outcomes following ectopic pregnancy are no worse than those in women in their first pregnancy."

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