Abstract
We estimated the incidence of ectopic pregnancy (EP) and the success rate of expectant management of EP in South Korea. We analyzed data from 2009 to 2015 using the Health Insurance Review and Assessment Service National Inpatient Sample (HIRA-NIS) database. EP was identified by diagnostic codes, and strict EP was identified by both diagnostic codes and treatment codes. From 2009 to 2015, 369,701 cases of EP, abortion, or delivery were extracted from a total of 4,476,495 women. Of the total pregnancies, 8,556 cases were EPs. The incidence of EP was 34.1 ± 0.7 per 1,000 pregnancies and the incidence of strict EP was 17.3 ± 0.3 per 1,000 pregnancies. Among women aged 25–44 years, age was associated with a higher incidence of EP (odds ratio [OR]: 1.13; 95% confidence interval [CI]: 1.06, 1.19; P < 0.01). The incidence rates of EP (OR: 0.99; 95% CI: 0.97, 1.01; P = 0.51) did not significantly differ by year. The incidence of EP in Korea was 17.3 ± 0.3 per 1,000 pregnancies, and almost did not change over 7 years. About 50% of EPs were treated without surgery or methotrexate. This study provides an important reference for the treatment of EP.
Highlights
The overall incidence of ectopic pregnancy (EP) was 19.7 per 1,000 pregnancies in 1992, the last time national data were reported by the U.S Centers for Disease Control and Prevention[4]
Expectant management is considered for some visible EPs, in cases of pregnancy of unknown location (PUL) when there are low or plateauing serum human chorionic gonadotropin concentrations[13,14]
According to weighted logistic regression analyses adjusted for year and age, the incidence of EP and the incidence of strict EP (OR: 1.12; 95% CI: 1.07, 1.17; P < 0.01) increased with age but did not change by year (EP OR: 0.99; 95% CI: 0.97,1.01; P = 0.51; strict EP OR: 1.01; 95% CI: 1.00, 1.03; P = 0.13)
Summary
The overall incidence of EP was 19.7 per 1,000 pregnancies in 1992, the last time national data were reported by the U.S Centers for Disease Control and Prevention[4]. Management is based on the knowledge that the natural history of many early EPs is a self-limiting process that results in tubal abortion or reabsorption[15,16]. Improved diagnostic methods, such as more sensitive pregnancy tests and high-grade vaginal ultrasonography, have made it possible to diagnosis EP early, including PUL, before the patient’s condition has deteriorated. We estimated the incidence of EP in Korea from 2009 to 2015, and the success rate of expectant management of EP using the Korean Health Insurance Review and Assessment Service National Inpatient Sample (HIRA-NIS) database
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