If a woman has an ectopic pregnancy, what is her risk of having another one? Does a history of ectopic pregnancy influence the outcomes of future intrauterine pregnancies?
These questions were addressed in a large, population-based cohort study that evaluated the outcomes of intrauterine pregnancies among 1,117,571 women with a previous surgically treated extrauterine pregnancy. This cohort of women, who had been pregnant between 1989 and 2013, included 15,823 women who had a surgically treated ectopic first pregnancy (exposed group) and a control group of women whose first pregnancy was intrauterine (nonexposed group).
The key findings:
The exposed group had a higher risk for an ectopic second pregnancy, and this risk was higher after salpingostomy versus salpingectomy.
The risk for an adverse pregnancy outcome was higher among those with surgically treated ectopic first pregnancy; adverse outcomes included preterm birth, low birth weight, and need for cesarean section.
The risks for preeclampsia, placenta previa, ICU admission, multiple birth, gestational diabetes, and blood transfusion were also higher among women with an ectopic first pregnancy.
Women over the age of 30 with a previously surgically treated ectopic pregnancy had a greater risk for placental abruption in a subsequent pregnancy.
Viewpoint
In about 2% of pregnancies
