Ruptured ectopic rate
9 studies including 1531 women compared the number of ruptured ectopic pregnancies during Covid to a matched pre-Covid cohort (2,6,21-27). Data collected from these studies were analysed to compare the rate of rupture between the two cohorts. During the Covid pandemic 99/564cases of ruptured ectopic were reported versus 179/967 in the pre-Covid cohort. (Appendix S2)
Random effects meta-analysis revealed that during Covid there was an increased pooled risk of rupture rate [OR 1.91 (1.01-3.61), p=0.01 I2=60%]. However, sensitivity analysis focused on EPU structures revealed no difference in the pooled risk of rupture rate during the Covid pandemic [OR= 0.66 (0.33-1.31), p=0.24, I2=37%]. In contrast, in NEPU structures there was a clear increase pooled risk of ruptured ectopic pregnancy at presentation [OR=2.86(1.84-4.46), p<0.01 I2=13%].