National trends in the management of tubal pregnancy, 1970-1987.
Tubal pregnancy leads to reduced childbearing potential and is a major cause of maternal morbidity and mortality in the United States. Several hospital-based studies have shown a trend toward more conservative management of tubal pregnancies, which reflects attempts to reduce morbidity and preserve fertility; however, the impact on future fertility remains unclear. To study national trends in the management of tubal pregnancy from 1970-1987, we analyzed data from the National Hospital Discharge Survey. Tubal pregnancies managed conservatively, using operative procedures that attempt to preserve the function of the involved fallopian tube, increased from approximately 2% in 1970-1978 to 12% in 1984-1987. During 1979-1987, conservative procedures were more than twice as common for women with private insurance as for those without it. The use of diagnostic laparoscopy increased from 10% of tubal pregnancies in 1970-1978 to 33% in 1979-1987, whereas the use of diagnostic laparotomy decreased from 24 to 2%.
Young
P L
PL
Division of Reproductive Health, Centers for Disease Control, Altanta, Georgia.
Saftlas
A F
AF
Atrash
H K
HK
Lawson
H W
HW
Petrey
F F
FF
D000328:Adult; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D015994:Incidence; D010535:Laparoscopy / Q000706:statistics & numerical data; D007813:Laparotomy / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D010052:Ovariectomy / Q000706:statistics & numerical data; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000453:epidemiology / Q000601:surgery*; D012489:Salpingostomy / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology