Ectopic pregnancy in China during 2011–2020: a single-centre retrospective study of 9499 cases

Abstract

Background Previous studies have shown that the incidence of ectopic pregnancy (EP) is increasing in China. It is unclear, however, whether the incidence of EP has changed after the implementation of the universal two-child policy in the context of China’s aging population and declining fertility rate. Methods Data concerning EP from January 2011 to December 2020 were collected from the hospital’s electronic medical records, which included the annual number of delivery, caesarean section rate, ectopic pregnancies, treatment of tubal pregnancy, and average costs and length of hospitalization. Trends of the EP incidence were analysed and annual percentage change (APC) was calculated using connected point regression analyses. Results A total of 9499 cases of EP were collected, among which caesarean scar pregnancy (CSP) accounts for the second highest (6.73%). The EP per 100 deliveries revealed a downward trend, from 7.60% in 2011 to 4.28% in 2020 with an APC of -1.87 (P < 0.05). The maternal age was increased, especially after the implementation of the universal two-child policy. The constituent ratio for the advanced maternal age (≥ 35) and the caesarean section rate, but not the CSP, were also increased. Laparoscopic salpingectomy was the main surgical method, whereas the adoption of laparotomy and laparoscopic salpingostomy was decreasing year by year. Conclusions Although no obvious effect of the two-child policy on EP has been observed under the conditions of this study, the change in EP especially in advanced-age women after the policy implementation needs further evaluation. A decreased caesarean section rate, in primipara is beneficial to reducing the CSP.

The impact of maternal electrolyte and albumin levels on the efficacy of single-dose methotrexate treatment for ectopic pregnancies

“…Ectopic pregnancy represents a significant gynecological concern with implications for maternal mortality and morbidity ( 16 , 17 ) . Methotrexate (MTX) typically serves as the primary treatment option for stable cases of unruptured ectopic pregnancies.…”

Complicaciones obstétricas y edad materna avanzada

“…Por otro lado, el embarazo ectópico también se relaciona con la edad materna. La edad materna de 35 años o más se asocia a 4 a 8 más riesgo de embarazo ectópico en comparación con mujeres más jóvenes (20,24) (tabla 1). Esta alta incidencia en mujeres de mayor edad puede ser un reflejo de factores de riesgo acumulativos a lo largo del tiempo.…”

Reasons, experiences and expectations of women with delayed medical care for ectopic pregnancies in Chinese urban edges: a qualitative study

“…The incidences of ectopic pregnancy vary in different regions of the world. For example, the incidences of ectopic pregnancy were reported from 7.0‰ to 8.3‰ during 2006–2010 in the USA,2 whereas, in China, the incidence of ectopic pregnancy decreased from 7.6% in 2011 to 4.3% in 2020, probably due to improved contraceptive knowledge and a decreased prevalence of sexually transmitted diseases 3…”

“…For example, the incidences of ectopic pregnancy were reported from 7.0‰ to 8.3‰ during 2006-2010 in the USA, 2 whereas, in China, the incidence of ectopic pregnancy decreased from 7.6% in 2011 to 4.3% in 2020, probably due to improved contraceptive knowledge and a decreased prevalence of sexually transmitted diseases. 3 Ectopic pregnancy is a medical emergency and the leading cause of death in early pregnancy. 4 An embryo in the fallopian tube can cause it to rupture with subsequent intraabdominal haemorrhage.…”