1253 A Descriptive Analysis of Anomalous Ectopic Pregnancies

Abstract

Study Objective The majority of ectopic pregnancies implant in the fallopian tube; however, 10% implant in non-tubal locations including the abdominal cavity, cervix, ovary, interstitium of the fallopian tube, broad ligament, uterine cornua, and cesarean section scar. The objective of this study is to describe the characteristics and history of patients presenting with anomalous ectopics encountered at North Shore University Hospital/Long Island Jewish (NSUH/LIJ) from 2016 to 2018. Design A descriptive analysis of the anomalous ectopics encountered at NSUH/LIJ from 2016 to 2018. Setting Patients presented to the emergency room and were treated medically or in an operating room setting at NSUH/LIJ. Patients or Participants 55 women of reproductive age presented to NSUH/LIJ with pelvic pain and a positive bHCG and were determined to have an ectopic pregnancy in a non-tubal location. Interventions Patients with heterotopic, ovarian, cervical, cesarean section scar and interstitial ectopics were primarily treated via minimally invasive laparoscopic excision. Those with cesarean section scar and cervical ectopics were managed with methotrexate and intracervical balloons. Measurements and Main Results The incidence of patients with anomalous ectopics was 13.6%. The average age at diagnosis was 35. 74.5% in this cohort reported to be never smokers. 74.5% reported having previous abdomino-pelvic surgery. 74.5% did not use ART prior to their presenting diagnosis. The breakdown of ectopics was- Cesarean scar (27.3%), Cornual (23.6%), Interstitial (20.0%), Cervical (16.4%), Heterotopic (5.5%), Abdominal (3.6%), and Ovarian (3.6%). Conclusion Anomalous ectopic pregnancies in the NSUH/LIJ population of patients are 3.6% more prevalent than that reported by current data. Although these patients did not report use of ART in association with the anomalous pregnancy, many of these patients reported having previous abdominopelvic surgeries. C-section scar ectopics were the most prevalent, which may be secondary to the higher rate of c-sections in the last decade.