Outcomes in subsequent pregnancies after wedge resection for interstitial ectopic pregnancy: a retrospective cohort study

J Matern Fetal Neonatal Med. 2019 Jul;32(14):2354-2360. doi: 10.1080/14767058.2018.1437411. Epub 2018 Feb 15.

Abstract

Objective: The objective of this study is to evaluate pregnancy outcomes in patients with a history of wedge resection for interstitial ectopic pregnancy (WRIEP).

Methods: Retrospective cohort study of pregnancies with a history of WRIEP from 2000 to 2013 at two inner city hospitals in Detroit, MI. Pregnant-matched controls (1:3) were selected and included patients with history of surgically treated tubal ectopic pregnancy and delivered patients without history of ectopic pregnancy. Pregnancy outcomes, including a composite, were compared among the groups.

Results: Eighty-three cases of interstitial pregnancy were identified. Sixty-three (75.9%) underwent WRIEP from which 19 (30.2%) had a subsequent pregnancy and 11 (57.9%) carried it ≥20 weeks. No difference in subsequent pregnancy outcomes including the composite was found among patients with prior WRIEP and patients with history of surgically treated tubal ectopic pregnancy except for a longer interpregnancy interval. Compared with delivered patients without a history of ectopic pregnancy, no difference in late obstetric outcomes was found including the composite, gestational age at delivery in weeks (38.2 versus 38.1, p = .955), preterm delivery rate (30% versus 21%, p = .674), and proportion of term vaginal (40% versus 52%, p = .721) or cesarean deliveries (60% versus 30%, p = .137). The most common indication for cesarean among patients with a history of WRIEP was a history of such (5/6, 83.3%) and there were no cases of abnormal placentation.

Conclusion: Findings suggest that a history of WRIEP is not associated with increased risk of adverse pregnancy outcomes.

Keywords: Cornual ectopic pregnancy; cornual resection; interstitial ectopic pregnancy; obstetrical outcomes; pregnancy outcomes; wedge resection.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Female
  • Humans
  • Logistic Models
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Pregnancy, Interstitial / surgery*
  • Retrospective Studies
  • Young Adult