Impact of Coronavirus Disease 2019 (COVID-19) on emergency department visits for ectopic pregnancies in New York City

Abstract

Background: Ectopic pregnancy is a potential cause of morbidity and mortality among women and is a common diagnosis for women presenting to the emergency room. During the height of the COVID-19 pandemic in New York City (NYC) in the spring of 2020, emergency room visits for all non-COVID related health problems appeared to decrease. We examined visits for ectopic pregnancies and pregnancies of unknown location (PUL) in the emergency department (ED) of three NYC hospitals during the height of the early pandemic and compared them to the same months in the prior year. Methods: Our study is an IRB-approved retrospective chart review of all patients who presented to the ED with a positive pregnancy test during the months of March–June 2020 (pandemic period) and March–June 2019 (pre-pandemic). Demographic data, history, labs, imaging, number of visits and treatment and outcomes were measured. Results: We found that there were 324 ED visits for PUL in 2019 (pre-pandemic) compared to 195 in 2020 (pandemic). Ectopic pregnancies remained somewhat stable and were diagnosed in 59 patients in 2019 and 51 patients in 2020. The percentage of patients diagnosed with ectopic pregnancy increased from 25.1% of all patients with PUL in 2019 to 39% of all patients diagnosed with PUL in 2020. Rates of complications were similar between the two cohorts. Conclusion: Although the number of visits to the ED for PUL fell dramatically from the pre-pandemic to the pandemic time period, the number of patients actually diagnosed with ectopic pregnancy was similar between the two time periods.

Keywords

• ectopic pregnancy
• emergency department
• covid-19