loading page

To fight or to flee? -- a systematic review of ectopic pregnancy management during Covid-19.
  • +2
  • Amelie Morin,
  • Michail Sideris,
  • Sophie Platts,
  • Tetyana Palamarchuk,
  • Funlayo Odejinmi
Amelie Morin
Whipps Cross University Hospital

Corresponding Author:[email protected]

Author Profile
Michail Sideris
Queen Mary University of London
Author Profile
Sophie Platts
Whipps Cross University Hospital
Author Profile
Tetyana Palamarchuk
Whipps Cross University Hospital
Author Profile
Funlayo Odejinmi
Whipps Cross University Hospital
Author Profile


Background: Concerns about virus spread during surgery contributed to changes in the clinical management of ectopic pregnancies (EP) during the COVID19 pandemic. Objective: To compare published data on EP management prior versus during the COVID-19 pandemic and evaluate any difference in the management, rupture rate and complications where Early Pregnancy Unit (EPU) structures exist. Search strategy: We performed a systematic review of the literature using a keyword strategy based on our PICO criteria. Selection criteria: We included studies which recruited women diagnosed with ectopic pregnancy and compared the management during and prior the COVID-19 pandemic peak. Data collection and Analysis: Three independent reviewers screened the literature and extracted the data. Meta-analysis of the data was performed on Revman. Main Results: Our search yielded 34 studies; 12 were included in our meta-analysis (3122 women). We found no difference in the type of management of EP between the pre-Covid and Covid cohorts [2714 women, OR 0.99(0.63-1.55), p=0.96, I2=77%]. We observed a non-statistically significant reduction of surgical management within the EPU branch ([OR 0.47(0.19-1.13), p=0.09, I2=81%]). There was no difference in the ectopic rupture rate in units with EPU [OR= 0.66 (0.33-1.31), p=0.24, I2=37%]. In contrast, in non-EPU (NPEU) the risk of ruptured EP [OR=2.86(1.84-4.46), p<0.01 I2=13%] and complications [OR=1.69(1.23-2.31), p=0.001, I2=45%] were increased. Conclusions: The worldwide trend was not reflected in the UK suggesting that EPU may have contributed to prompt diagnosis and safe management of EP. Funding: No funding was received. Keywords: ectopic pregnancy, COVID 19, meta-analysis, early pregnancy unit
03 Dec 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
14 Dec 2021Assigned to Editor
14 Dec 2021Submission Checks Completed
28 Dec 2021Reviewer(s) Assigned
06 Mar 2022Review(s) Completed, Editorial Evaluation Pending