Effect of the COVID-19 Pandemic on Ectopic Pregnancy Outcomes

STUDY OBJECTIVE: The purpose of this study was to evaluate the effect of the COVID-19 pandemic on the ectopic pregnancy surgical volume, both ruptured and stable cases, at a New York City high-volume, tertiary-care center. DESIGN: A retrospective chart review of 2 years of ectopic pregnancy surgical case volume. The time period evaluated included March 2019-February 2020 prior to the COVID-19 pandemic in New York City followed by March 2020-February 2021 when hospital services shifted to care of such patients. SETTING: N/A. PATIENTS OR PARTICIPANTS: All patients who underwent emergent gynecological surgery for ectopic pregnancies were reviewed by weekly and monthly volume over a 2-year period. Further review of ruptured as compared to unruptured cases was performed, with particular interest regarding hemoperitoneum at time of abdominal entry. INTERVENTIONS: N/A. MEASUREMENTS AND MAIN RESULTS: There was no significant difference (t(21) = 0.52, p = 0.612) between the pre-pandemic year March 2019 – February 2020 with a total of 33 ectopic cases (mean monthly volume 2.75, SD = 1.42) as compared to March 2020 – February 2021 total of 37 ectopic cases (mean monthly volume 3.08, SD = 1.73). There was no significant difference (t(22) = 0.56, p = 0.583) regarding ruptured ectopic case volume between 2019-2020 and 2020-2021 (total of 23 and 27, mean monthly volume 1.92 and 2.25 respectively). Finally, for ruptured ectopic cases, the mean estimated hemoperitoneum encountered upon entry into the abdomen (excluding subsequent operative blood loss) was 184.29 cc pre-pandemic and 244.8 cc during the pandemic with no significant difference between the years (t (44) = 1.18, p = 0.244). CONCLUSION: There were no significant differences in ectopic case volume prior and after the COVID-19 pandemic and no significant differences in hemoperitoneum upon abdominal entry, suggesting that the fear of the pandemic was not a deterrent to care for patients needing emergent ectopic surgery.