Impact of SARS-Cov-2 on ectopic pregnancies management in the United Kingdom: a multicentre observational study.

OBJECTIVE: to describe the impact of COVID-19 on the management of women with ectopic pregnancy. DESIGN: a multicentre observational study comparing outcomes from a prospective cohort during the pandemic [Covid-ectopic pregnancy registry (CEPR)] compared to an historical pre-pandemic cohort [non-Covid ectopic pregnancy registry (NCEPR)]. SETTING: five London university hospitals. POPULATION AND METHODS: consecutive patients diagnosed clinically and/or radiologically with ectopic pregnancy (March/2020-Aug/2020) were entered into the CEPR and results were compared to the NCEPR cohort (January/2019-June/2019). An adjusted analysis was performed for potentially confounding variables. MAIN OUTCOME MEASURES: patient demographics, management (expectant, medical and surgical), length of treatment, number of hospital visits (non-surgical management), length of stay (surgical management) and 30-day complications. RESULTS: 341 patients met inclusion: 162 CEPR and 179 NCEPR. A significantly lower percentage of women underwent surgical management versus non-surgical management in the CEPR versus NCEPR (58.6% [95/162] vs 72.6% [130/179]; p= 0.007]. Amongst patients managed with expectant management the CEPR had a significantly lower mean number of hospital visits compared to NCEPR [3.0 [IQR 2.0] vs 9.0 [IQR 9.0], p= <0.001]. Amongst patients managed with medical management, the CEPR had a significantly lower median number of hospital visits vs NCEPR (6.0 [IQR 3.0] vs 9 [IQR 4.0], p= 0.003]. There was no observed difference in complication rates between cohorts. CONCLUSION: women were found to undergo significantly higher rates of non-surgical management during COVID-19 first wave compared with a pre-pandemic cohort. Women managed non-surgically in CPER cohort were also managed with fewer hospital attendances. This did not lead to an increase in observed complications rates.