Ectopic Pregnancy and Emergency Contraceptive Pills

Abstract

Objective To evaluate the existing data to estimate the rate of ectopic pregnancy among emergency contraceptive pill treatment failures. Data Sources Our initial reference list was generated from a 2008 Cochrane review of emergency contraception. In August 2009, we searched Biosys Previews, the Cochrane Database of Systematic Reviews, Medline, Global Health Database, Health Source: Popline, and Wanfang Data (a Chinese database). Methods of Study Selection This study included data from 136 studies which followed a defined population of women treated one time with emergency contraceptive pills (either mifepristone or levonorgestrel), and in which the number and location of pregnancies were ascertained. Results Data from each article were abstracted independently by two reviewers. In the studies of mifepristone, 3 out of 494 (0.6%) pregnancies were ectopic; in the levonorgestrel studies, 3 out of 307 (1%) were ectopic. Conclusion The rate of ectopic pregnancy when treatment with emergency contraceptive pills fails does not exceed the rate observed in the general population. Since emergency contraceptive pills are effective in lowering the risk of pregnancy, their use should reduce the chance that an act of intercourse will result in ectopic pregnancy.

Ectopic pregnancy after levonorgestrel emergency contraception

“…5 After the occurrence of a few cases of ectopic pregnancies following the failure of LNG-EC, it is recommended in several countries that in case of a conception following a failed EC with LNG, the possibility of ectopic pregnancy should be considered. 6 Although the risk of ectopic pregnancy increases with alterations in the tubal motility and ciliary dysfunction caused by LNG, in a systematic review conducted by Cleland et al, 6 ectopic pregnancy rate is reported as 1% among women exposed to LNG-EC, while the risk of ectopic pregnancy among women that did not use EC pills was 0.8 to 2%. Therefore, they concluded that risk of ectopic pregnancy after failed EC pills was not greater than the risk observed in the general population.…”

Emergency Contraception

“…Bu da LNG'nin fallop tüpü motilitesini etkilemediğinin bir göstergesidir 16 . LNG kullanımında en sık görülen yan etkiler bulantı, kusma ve irregüler vajinal kanamalardır.…”

Emergency Contraception Review

“…A systematic review found that when ECPs fail, the proportion of pregnancies that are ectopic does not exceed the proportion of ectopic pregnancies in the general population. 48 Like all contraceptive methods, ECPs reduce the absolute risk of ectopic pregnancy by preventing pregnancy in general.…”