Role of previous ectopic pregnancy in altering the presentation of suspected ectopic pregnancy.
OBJECTIVE
To evaluate the differences in the presentations of women with and without a prior history of an ectopic pregnancy and a suspicion of a current ectopic.


METHODS
Evaluation of a cohort of patients presenting to an emergency department to exclude an ectopic pregnancy. Over a 58-month study period (January 1992-October 1996), 1,510 consecutive, pregnant women presenting to an emergency department with pelvic pain and/or vaginal bleeding to exclude an ectopic pregnancy were evaluated. A comparison was made of the presenting signs and symptoms between patients with and without a previous history of an ectopic pregnancy.


RESULTS
Of patients presenting to exclude an ectopic pregnancy, 105 had a history of an ectopic pregnancy, and 1,355 had no such history. Fifty patients were excluded because they were lost to follow-up or transferred their care to another hospital. Those with a history of an ectopic pregnancy were more likely to be diagnosed again with an ectopic pregnancy, were older and were more likely to have a history of pelvic inflammatory disease and abdominal surgery. Patients with a history of an ectopic pregnancy presented earlier with a lower hCG level.


CONCLUSIONS
Women with a previous history of an ectopic present in a clinically different manner than do those without such a history.
Spandorfer
Steven D
SD
Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, Weill Medical College, Cornell University, New York, New York, USA. sdspando@med.cornell.edu
Barnhart
Kurt T
KT
D000328:Adult; D000367:Age Factors; D006063:Chorionic Gonadotropin / Q000097:blood; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D005831:Genital Diseases, Female / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors
D006063:Chorionic Gonadotropin