Sudden death: Ectopic pregnancy mortality Review

Anderson, FWJ, Hogan, JG, Ansbacher, R. (2004). Sudden death: Ectopic pregnancy mortality . Obstetrics and Gynecology, 103(6), 1218-1223. 10.1097/01.AOG.0000127595.54974.0c

cited authors

  • Anderson, FWJ; Hogan, JG; Ansbacher, R

abstract

  • OBJECTIVE: To describe the trends in ectopic pregnancy mortality in Michigan from 1985 through 1999 and compare to those of previous time periods. METHODS: We reviewed all cases of maternal mortality from ectopic pregnancy in Michigan from 1985 through 1999. We extracted data from death certificates, hospital inpatient and emergency department records, medical examiner autopsy reports, and reviews by the Michigan Maternal Mortality Study. The Health Data Development Section of the Michigan Department of Community Health provided data on live births and maternal deaths RESULTS: Of the 268 pregnancy-related deaths, 16 (6%) were caused by complications of ectopic pregnancy. Mean age at death was 27 (± 6) years. Thirteen deaths were to African-American women and 3 were to white women (P < .01). African-American women had an ectopic mortality ratio 18 times higher than white women (3.25/100,000 live births, compared with 0.18/100,000) Three cases of pregnancy-related death due to complications of ectopic pregnancy were considered preventable, and 2 others were of unknown preventability. CONCLUSION: Ectopic pregnancy treatment has changed in the last 20 years coincident with a decrease in maternal mortality from ectopic pregnancy. Sudden death was the presenting scenario in 75% of nonpreventable ectopic deaths, an increase from previous analyses. A large racial disparity is apparent. Ideally, pregnancy care should start as soon as possible after the first missed menses; however, systemwide changes are needed to create a new norm promoting early access to pregnancy care and promoting education and testing to rule out pregnancy abnormalities. © 2004 by The American College of Obstetricians and Gynecologists.

authors

publication date

  • June 1, 2004

published in

Digital Object Identifier (DOI)

start page

  • 1218

end page

  • 1223

volume

  • 103

issue

  • 6