Document Detail


Trends in the diagnosis and treatment of ectopic pregnancy in the United States.
MedLine Citation:
PMID:  20177279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate trends in the rates of diagnosis and treatment of ectopic pregnancy in the United States. METHODS: We analyzed data from a large administrative claims database of more than 200 U.S. commercial health plans, and estimated time trends in the rate and incidence of ectopic pregnancy among girls and women aged 15-44 years by 5-year age groups and by region from 2002 to 2007. We also estimated time trends in the proportion of cases that were treated surgically, either by laparoscopy or laparotomy, or medically with methotrexate. RESULTS: We identified 11,989 ectopic pregnancies during the period from 2002 to 2007. The overall rate of ectopic pregnancy among pregnant girls and women aged 15-44 years during the 6-year study period was 0.64%. We did not observe a trend in the rate of ectopic pregnancy by 5-year age group or by geographic region. The ectopic pregnancy rate increased with age; it was 0.3% among girls and women aged 15-19 years and 1.0% among women aged 35-44 years. Methotrexate treatment increased from 11.1% in 2002 to 35.1% in 2007 (P<.001); the methotrexate failure rate was 14.7% over the 6-year study period. Surgical management with laparotomy decreased over the study period from 40.0% to 33.1% (P<.001). CONCLUSION: We did not find an increasing or decreasing trend in the rate of ectopic pregnancy among U.S. commercially insured women from 2002 to 2007. The use of administrative claims data are likely the most feasible method for estimating the rate and monitoring trends of ectopic pregnancy in the United States.
Authors:
Karen W Hoover; Guoyu Tao; Charlotte K Kent
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  115     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-23     Completed Date:  2010-03-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  495-502     Citation Subset:  AIM; IM    
Affiliation:
Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. khoover@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents / therapeutic use
Adolescent
Adult
Age Distribution
Female
Humans
Incidence
Methotrexate / therapeutic use
Pregnancy
Pregnancy, Ectopic / drug therapy,  epidemiology*,  surgery
United States / epidemiology
Young Adult
Chemical
Reg. No./Substance:
0/Abortifacient Agents; 59-05-2/Methotrexate
Comments/Corrections
Comment In:
Obstet Gynecol. 2010 Mar;115(3):487-8   [PMID:  20177277 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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