Surgical versus non-surgical management
10 studies involving 2714 women, reported on the method of management of ectopic pregnancies during Covid compared to a pre-Covid cohort (2,3,6)(21-27). A total of 719 women underwent surgical management in the pre-Covid cohort versus 551 in the Covid cohort. In the pre-Covid cohort, 761 patients with ectopic pregnancy were managed non-surgically compared with 669 women in the Covid cohort. Details of women managed medically with methotrexate and conservatively can be found in Appendix S1.
Overall there was no difference in the type of management (surgical versus non-surgical) [OR 0.99(0.63-1.55), p=0.96, I2=77%] in the pre-Covid vs Covid cohorts. A similar trend was reported in the NEPU group [OR=1.40(0.89-2.20), p=0.15, I2=58%]. In the EPU group there was an increased trend of non-surgical management, however, overall this was not statistically significant [OR 0.47(0.19-1.13), p=0.09, I2=81%].