Complications following minimally invasive surgical treatment of ectopic pregnancy - with a particular focus on interstitial pregnancies: a retrospective cohort study

OBJECTIVE: To examine and describe post-operative complications following surgical treatment of ectopic pregnancy and interstitial pregnancy.

METHODS: We conducted a retrospective cohort study based on data from two Danish university hospitals. The study included medical records of 646 women with surgically treated ectopic pregnancies from 1/1-2017 to 31/12-2020 at Herlev Hospital and 1/1-2018 to 3/6-2021 at Hvidovre Hospital. Data were extracted from electronic medical records and included patient demography, risk factors, comorbidities, as well as perioperative and postoperative outcomes such as readmissions, reoperations, and antibiotic use.

MAIN OUTCOME MEASURES: Post-operative complications rated by type and graded according to the Clavien-Dindo classification system. Opioid use, time from admission to surgery, and complication severity were reviewed and compared with hemorrhage at the time of surgery.

RESULTS: All patients with bleeding over 2,000 mL had surgery within six hours of admission, and all patients over 3000 mL had surgery within three hours. At least one postoperative complication occurred in 89 (13.7 %) patients; nine patients (1.4 %) developed severe complications (CD > 2), and no patients died. Seven (1.1 %) patients needed re-operation. There was no significant correlation between hemorrhage and complication severity (P 0.87) or hemorrhage and opioid use (P 0.098).

CONCLUSION: Minimally invasive surgical treatment was safe and feasible even in patients with extensive bleeding or interstitial pregnancy.