National trends in the management of tubal pregnancy, 1970-1987

Article Abstract:

Tubal pregnancy occurs when a fertilized egg begins to develop inside of the fallopian tube instead of the uterus. This has serious consequences because if it is not diagnosed and treated it can cause the fallopian tube to rupture, and this will reduce the ability to have another pregnancy. Tubal pregnancy can sometimes result in the death of the mother. The traditional treatment for tubal pregnancy has been to surgically remove the affected tube. However, a more conservative approach is being tested. Instead of removing the tube, attempts are being made to surgically remove the fertilized egg from the tube without permanently damaging the tube. It is hoped that this will reduce mortality and preserve fertility. In order to determine how popular this procedure is, data from the National Hospital Discharge Survey, conducted by the Centers for Disease Control, were analyzed. Between 1970 and 1987, 95 percent of all ectopic pregnancies (pregnancies occurring outside of the uterus) were tubal pregnancies. During this period there were 684,914 reported cases of tubal pregnancy. The majority of these cases occurred between 1979 and 1987. During the study period, the use of conservative surgery for treating tubal pregnancy increased from 2 to 12 percent. The average age of women undergoing conservative surgery increased from 24.5 to 27 during the study period. Those who were treated with conservative surgery spent less time in the hospital. In this same period, the use of laparoscopy (a procedure used to for examining the inside of the abdominal and pelvic cavity) for diagnosing tubal pregnancy rose from 10 percent to 33 percent, while the use of diagnostic laparotomy (removal of a tissue sample for examination) decreased from 24 percent to 2 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Surgery, Pregnancy, Ectopic, Ectopic pregnancy

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The epidemiology of placenta previa in the United States, 1979 through 1987

Article Abstract:

Women from different minority groups may have a higher risk of placenta previa than white women. Placenta previa is a placenta that develops in the lower portion of the uterus so that it covers or adjoins its opening. A study examined the incidence of placenta previa among women who delivered a live or stillborn infant in the hospital between 1979 and 1987. Approximately 0.5% of the deliveries each year were complicated by placenta previa. Its incidence rose among black women and women from other minority groups, but remained the same among white women. Black women and minority women had a higher risk of placenta previa than white women. Older women also had a higher risk than younger women. Women with placenta previa were more likely to have a cesarean section or to develop abruptio placenta. Abruptio placenta is premature detachment of the placenta.

Demographic aspects, Pregnancy, Complications of, Pregnancy complications, Placenta praevia, Placenta previa

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