Sequelae and prognosis

Sequelae will vary according to an individual's risk factors and the means of management employed.

Illustrative figures are presented for surgical and medical management:

• laparoscopic salpingostomy - of 976 patients treated, 94% did not require any additional procedure.
• systemic methotrexate - of 306 patients treated, 94% did not require any additional therapy.

The risk of ectopic pregnancy reoccurring is

• around 10% in women with one previous ectopic pregnancy
• at least 25% in women with two or more previous ectopic pregnancies (1)

According to population based cohort studies done on subsequent pregnancies after an ectopic pregnancy,

• regardless of the treatment method (surgical or medical), 66% of women conceived after therapy with 90% reporting intrauterine pregnancy and 10% with recurrent ectopic pregnancy
• around 62-70% intrauterine pregnancies and around 8% recurrent ectopic pregnancies were seen after methotrexate treatment (2)

Although maternal death from ectopic pregnancy has decreased, it is still the leading cause of death in the first trimester (2)

• in UK there were 10 maternal deaths due to ectopic pregnancy between 2003-2005 (3)

Reference:

• 1. Barnhart KT. Clinical practice. Ectopic pregnancy. N Engl J Med. 200923;361(4):379-87
• 2. Tay JI, Moore J, Walker JJ. Ectopic pregnancy. BMJ. 2000;320(7239):916-9
• 3. Confidential Enquiry into Maternal and Child Health (CEMACH) 2007. Saving mothers' life:Reviewing maternal deaths to make motherhood safer - 2003-2005