Assessing the risk factors and management outcomes of ectopic pregnancy: A retrospective case-control study

Background: Ectopic pregnancy (EP) is the implantation of a fertilized egg outside the uterine cavity or in an unusual location. According to the clinical case reports, hormonal contraceptive failures may be related to emergency contraceptives and EP. EP may be treated medically, surgically, or expectantly. Currently, there is no consensus regarding whether a multiple- or double-dose regimen with methotrexate (MTX) or an additional dose could be more effective than a single-dose regimen. Objective: This study aimed to assess risk factors and treatment outcomes for EP. Materials and Methods: This case-control study was carried out in Tehran, Iran from March ۲۰۲۰-March ۲۰۲۱. The case group was comprised of all EP-diagnosed cases (n = ۱۹۱). Based on the levels of β-human chorionic gonadotropin, MTX was administered to stable individuals with no surgical indications. Risk factors were assessed through ۲ control groups: intrauterine pregnancy (n = ۱۹۰) and nonpregnant groups (n = ۱۸۰). Results: The medical treatment significantly improved with an extra dose of MTX, especially in individuals with higher β-human chorionic gonadotropin concentrations and gestational age > ۷.۵ wk (p = ۰.۰۰۲). Considering risk factors, it is assumed that hormonal contraceptive failures, including both oral and emergency contraceptives, may increase the EP likelihood (p < ۰.۰۰۱). Conclusion: Based on our findings, we recommended an additional dose of MTX for subjects who are further along in their pregnancy. It is also concluded that failure of contraceptive pills increases the chances of EP.

Keywords:

Contraception , Ectopic pregnancy , Intrauterine device , Levonorgestrel. , داروهای پیشگیری از بارداری , حاملگی خارج رحمی , آیودی , لوونورژسترن.