Declining incidence of ectopic pregnancy in a UK city health district between 1990 and 1999

BACKGROUND: On the basis of clinical impression that the number of cases of ectopic pregnancy seen in the City and Hackney Health District, London, was changing, a retrospective study of the years between 1990 and 1999 was carried out. METHODS: From the histopathology databases, cases of ectopic pregnancy and early pregnancy failure were identified. The number of deliveries at The Homerton Hospital was obtained from the Labour Ward register; the number of terminations of pregnancy and the number of fertile women was obtained from the Office for National Statistics, UK. RESULTS: There were 73 cases of ectopic pregnancy in 1990 rising to 96 in 1991 and then a fall to 52 cases in 1999. In terms of ectopic pregnancy per 100 deliveries, per all known pregnancies and per 1000 fertile women per year, there was a peak in 1991 and a fall to 1999. With regard to relative incidence per deliveries and per all known pregnancies, these falls were significant (P < 0.05). In 1991, there were 2.4 ectopic pregnancies per 100 deliveries, falling to 1.6 in 1999, a 33% fall. The reasons for this large decline are uncertain. CONCLUSIONS: There has been no change in patient population, diagnostic aids used or management protocols for patients with ectopic pregnancies.