VP01.01: Ultrasound characteristics, serum biochemistry and outcomes for ectopic pregnancies presenting during the COVID‐19 pandemic: retrospective analysis

Abstract

To describe and compare the characteristics of ectopic pregnancies (EP) in the year prior to and then during the COVID-19 pandemic. This was a retrospective analysis from 1st January 2019 to 31st December 2020 of women diagnosed with an EP (n = 276) at a dual-centre early pregnancy assessment service in London. Women were identified via the AstraiaTM ultrasound reporting system using coded and non-coded outcomes of ‘EP’ or ‘pregnancy outside the uterine cavity’. Data relating to predefined outcomes were collected using AstraiaTM and CernerTM electronic reporting systems. Main outcome measures included clinical, ultrasound and biochemical features of EP, in addition to reported complications and management. Statistical analysis was carried out using GraphPad Prism v8.2.1. Similar numbers of EP were seen in 2019 (n = 141) and 2020 (n = 135). Both cohorts were comparable in age, ethnicity, weight and method of conception. Gestational age at first ultrasound (41 vs 38 days, p = 0.11) and at diagnosis (42 vs 41 days, p = 0.25) was similar, with no difference in EP location, size or morphology. Human chorionic gonadotrophin (hCG) levels wat time of EP diagnosis were higher in 2020 than 2019 (1016 IU/L vs 665 IU/L, p = 0.02). The type of final EP management was similar, but more failed first line management during the pandemic (16% vs 6%, p = 0.01). Rates of hemoperitoneum (23% vs 27%, p = 0.58) and of rupture confirmed surgically (9% vs 3%, p = 0.07) were both low. No difference was observed in the location, size, morphology and gestational age of ectopic pregnancies. Complication rates and management were also unchanged. HCG levels were higher, and a greater proportion of conservative management measures failed during the pandemic. Our findings suggest women continued to access appropriate care for EP during the COVID-19 pandemic, with no evidence of diagnostic delay or increase in adverse outcomes in our population.