Non-tubal ectopic pregnancy: types of treatment and occurrence of severe complications in a university hospital.

Abstract

Objective: To evaluate the types of treatments used for non-tubal ectopic pregnancy (NTEP), the success rates of medical treatment, and the incidence of severe complications.

Methods: Retrospective study of all NTEP admitted in the University of Campinas (UNICAMP) Women's hospital, Brazil, from 01/01/2000 to 01/31/2023. Outcome variables were medical treatment success and the presence of severe complications. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out by the Cochran-Armitage and chi-square test.

Results: In total 60 cases of NTEP were included (3 abdominal, 15 cervical, 12 cesarean scar, 24 interstitial fallopian tube, 3 heterotopic e 3 ovarian). In cases of abdominal, cesarean scar, heterotopic and ovarian NTEP, the main type of treatment was surgery. Medical treatment was used mainly in cervical and interstitial NTEP (p<0.01). Medical treatment (included methotrexate single dose, multiple doses or direct injection) success rate was 73.7%, with no correlation with NTEP location (p=1.000). No change in trend was identified in the success rate of medical treatment for NTEP in the period evaluated (Cochran-Armitage test: z=0.46; p= 0.644). Severe complications occurred in 12(20) of NTEP, with no association with NTEP location (p=0.27), but with hemodynamic instability (p=0.01).

Conclusion: The medical treatment success rate found in our study for NTEP was similar to that reported in the medical literature for tubal EP. Two out of ten women with NTEP had severe complications. The occurrence of severe complications was not associated to the site of NTEP but to the presence of hemodynamic instability at admission.