A dedicated ectopic pregnancy team leads to an improvement in patients management

The aim of the study is to determine whether a dedicated ectopic pregnancy team improves the management of haemodynamically stable patients with suspected ectopic pregnancy who do not require immediate life-saving surgery.

Methods

A non-randomized population based study involving 210 patients admitted with a suspected ectopic pregnancy over a 2-year period in a university teaching hospital in the UK, was carried out to compare the management of those women before and after the introduction of the ectopic pregnancy team.

Results

Following the introduction of an ectopic pregnancy team, there were fewer laparotomies performed, fewer negative diagnostic laparoscopies, a reduced overall surgical intervention rate, and a reduced duration of hospital stay. Although, it was difficult to quantify the extent of improvement of training, yet there were fewer operations performed out-of-hours, more continuity of care, more learning opportunities and acquisition of laparoscopic skills of junior staff.

Conclusions

The introduction of an ectopic pregnancy team led to an improvement in the management of patients with suspected ectopic pregnancies. Efforts aiming at setting up such a specialized team and its implementation in day-to-day clinical practice should be considered in hospitals where the mainstay of treatment remains laparotomy.

Keywords Ectopic pregnancy - Dedicated team - Laparoscopic management
Oral presentation at the British Fertility Society Annual Meeting (2003), Aberdeen, UK. The study describes for the first time the significant improvement in management of patients with suspected ectopic pregnancies with the introduction of an ectopic pregnancy team.

Stuart Lavery, Salem A. El-Shawarby, Brianna Cloke, Raul Margara and Geoffrey Trew
Department of Reproductive Medicine and Surgery, Hammersmith Hospital, Imperial College School of Medicine, Du Cane Road, London, W12 OHS, UK

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