Steven D Spandorfer1, Kurt T Barnhart. 1. Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, Weill Medical College, Cornell University, New York, New York, USA. sdspando@med.cornell.edu
Abstract
OBJECTIVE: To evaluate the differences in the presentations of women with and without a prior history of an ectopic pregnancy and a suspicion of a current ectopic. STUDY DESIGN: Evaluation of a cohort of patients presenting to an emergency department to exclude an ectopic pregnancy. Over a 58-month study period (January 1992-October 1996), 1,510 consecutive, pregnant women presenting to an emergency department with pelvic pain and/or vaginal bleeding to exclude an ectopic pregnancy were evaluated. A comparison was made of the presenting signs and symptoms between patients with and without a previous history of an ectopic pregnancy. RESULTS: Of patients presenting to exclude an ectopic pregnancy, 105 had a history of an ectopic pregnancy, and 1,355 had no such history. Fifty patients were excluded because they were lost to follow-up or transferred their care to another hospital. Those with a history of an ectopic pregnancy were more likely to be diagnosed again with an ectopic pregnancy, were older and were more likely to have a history of pelvic inflammatory disease and abdominal surgery. Patients with a history of an ectopic pregnancy presented earlier with a lower hCG level. CONCLUSION: Women with a previous history of an ectopic present in a clinically different manner than do those without such a history.
OBJECTIVE: To evaluate the differences in the presentations of women with and without a prior history of an ectopic pregnancy and a suspicion of a current ectopic. STUDY DESIGN: Evaluation of a cohort of patients presenting to an emergency department to exclude an ectopic pregnancy. Over a 58-month study period (January 1992-October 1996), 1,510 consecutive, pregnant women presenting to an emergency department with pelvic pain and/or vaginal bleeding to exclude an ectopic pregnancy were evaluated. A comparison was made of the presenting signs and symptoms between patients with and without a previous history of an ectopic pregnancy. RESULTS: Of patients presenting to exclude an ectopic pregnancy, 105 had a history of an ectopic pregnancy, and 1,355 had no such history. Fifty patients were excluded because they were lost to follow-up or transferred their care to another hospital. Those with a history of an ectopic pregnancy were more likely to be diagnosed again with an ectopic pregnancy, were older and were more likely to have a history of pelvic inflammatory disease and abdominal surgery. Patients with a history of an ectopic pregnancy presented earlier with a lower hCG level. CONCLUSION:Women with a previous history of an ectopic present in a clinically different manner than do those without such a history.
Authors: Bruno C Casanova; Mary D Sammel; Jesse Chittams; Kelly Timbers; Jennifer L Kulp; Kurt T Barnhart Journal: J Womens Health (Larchmt) Date: 2009-02 Impact factor: 2.681