Ambulatory diagnosis and medical management of ectopic pregnancy in a public teaching hospital serving indigent women.
OBJECTIVE
The study was undertaken to evaluate the outcomes of indigent women with possible ectopic pregnancy who were cared for in a public teaching hospital outpatient clinic by multiple residents.


METHODS
Retrospective review of patients seen in the Obstetric-Gynecologic Urgent Care Center at Harbor-UCLA Medical Center from September 1, 2000, through August 30, 2001, was performed.


RESULTS
Of the 243 women being evaluated for possible ectopic pregnancy, 4 required surgical intervention during their diagnostic workup and 58 were lost to follow-up. Of the 31 women given methotrexate therapy, 25 successfully completed therapy, 2 required surgery, and 4 were lost to follow-up. Substantial investment was needed to contact patients who missed appointments.


CONCLUSIONS
It is feasible to manage women with possible ectopic pregnancies on an ambulatory basis in a public teaching hospital, but close oversight is needed and both staff and patients must commit to significant follow-up. Local protocols can be modified to reduce the numbers of visits required.
Nelson
Anita L
AL
Department of Obstetrics and Gynecology and the Research and Education Institute at Harbor-UCLA Medical Center, Torrance, 90509-2920, USA. AnitaNelsonWHC@earthlink.net
Adams
Yarameekah
Y
Nelson
LeRoy E
LE
Lahue
Anne K
AK
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005260:Female; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008489:Medical Indigency; D008499:Medical Records; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000628:therapy*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies
D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate