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Impact of SARS-Cov-2 on ectopic pregnancies management in the United Kingdom: a multicentre paired observational study
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  • Sophie Platts,
  • Jeewantha Ranawakagedon,
  • Reeba Oliver,
  • Sayantana Das,
  • Phalguni Kotabagi,
  • Christina Neophytou,
  • Neha Shah,
  • Matthew Toal,
  • Amelia Davison,
  • Mary Gbegbaje,
  • Kalpanas Rao,
  • Schahrazed Rouabhi,
  • Sandra Watson,
  • Funlayo Odejinmi
Sophie Platts
Whipps Cross University Hospital NHS Trust
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Jeewantha Ranawakagedon
Whipps Cross University Hospital NHS Trust
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Reeba Oliver
Whipps Cross University Hospital NHS Trust
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Sayantana Das
Homerton University Hospital
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Phalguni Kotabagi
North Middlesex University Hospital
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Christina Neophytou
The Royal London Hospital
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Neha Shah
Newham University Hospital NHS Trust
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Matthew Toal
Homerton University Hospital
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Amelia Davison
Homerton University Hospital
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Mary Gbegbaje
Barts Health NHS Trust
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Kalpanas Rao
Newham University Hospital NHS Trust
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Schahrazed Rouabhi
North Middlesex University Hospital
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Sandra Watson
Homerton University Hospital
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Funlayo Odejinmi
Barts Health NHS Trust
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Abstract

Objective: to describe the impact of COVID-19 on the management of patients with ectopic pregnancy. Design: a multicentre study comparing outcomes from a prospective cohort during the pandemic [Covid-ectopic pregnancy registry (CEPR)] compared to an historical pre-pandemic cohort [non-Covid ectopic pregnancy registry (NCEPR)]. Setting: five London university hospitals. Population and Methods: consecutive patients diagnosed clinically and/or radiologically with ectopic pregnancy (March/2020-Aug/2020) were entered into the CEPR and an exploratory matched analysis was performed comparing results to NCEPR patients (January/2019-June/2019). Main outcome measures: patient demographics, management (expectant, medical and surgical), length of treatment, number of hospital visits (non-surgical management), length of stay (surgical management) and 30-day complications. Results: 341 patients met inclusion: 162 CEPR and 179 NCEPR. A significantly higher percentage of women underwent non-surgical management versus surgical management in the CEPR versus NCEPR (58.6% [95/162] vs 72.6% [130/179]; p= 0.0084]. Amongst patients managed with expectant management the CEPR had a significantly lower mean number of hospital visits compared to NCEPR [3.6 [SD 1.4] vs 13.7 [SD 13.4], p= 0.0053]. Amongst patients managed with medical management, the CEPR had a significantly lower mean number of hospital visits [NCEPR 6.4 [SD 2.3] vs 8.8 [SD 3.9], p= 0.0014]. There was no observed difference in complication rates between cohorts. Conclusion: women were found to undergo significantly higher rates of non-surgical management during COVID-19 first wave vs NCEPR cohort. Women managed non-surgically in CPER cohort were also managed with fewer hospital attendances. This did not lead to an increase in observed complications rates.

Peer review status:ACCEPTED

26 Nov 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
26 Nov 2020Submission Checks Completed
26 Nov 2020Assigned to Editor
03 Dec 2020Reviewer(s) Assigned
07 Dec 2020Review(s) Completed, Editorial Evaluation Pending
27 Jan 2021Editorial Decision: Revise Major
28 Feb 20211st Revision Received
01 Mar 2021Assigned to Editor
01 Mar 2021Submission Checks Completed
02 Mar 2021Reviewer(s) Assigned
08 Mar 2021Review(s) Completed, Editorial Evaluation Pending
24 Mar 2021Editorial Decision: Revise Major
27 Apr 20212nd Revision Received
28 Apr 2021Assigned to Editor
28 Apr 2021Submission Checks Completed
28 Apr 2021Review(s) Completed, Editorial Evaluation Pending
03 May 2021Editorial Decision: Accept