Medical management of ectopic pregnancy in a family planning clinic: A case series

Abstract

Objective: To evaluate safety of medical management of ectopic pregnancy in a free-standing family planning clinic setting.

Study design: We retrospectively reviewed cases of ectopic pregnancy between January 2014 and December 2018 which were identified using a "Beta Board" tracking system. Planned Parenthood of Orange and San Bernardino Counties staff added patients the "Beta Board" if they had a positive urine pregnancy test without definitive ultrasound diagnosis of intrauterine pregnancy and/or symptoms suggestive of ectopic pregnancy, such as vaginal bleeding, and cramping. Patients were included in the study if they had received a final diagnosis of ectopic pregnancy.

Results: Of 5083 patients tracked via the Beta Board, 260 patients presented to a Planned Parenthood free-standing, family planning clinic with ectopic pregnancy. Ninety-five patients were treated with methotrexate entirely at the clinic. There were no deaths. Four ectopic pregnancies ruptured and 8 required surgery.

Conclusion: Treatment of ectopic pregnancy with methotrexate in the family planning clinic setting can be safe and effective with reassuring outcomes that are similar to the hospital setting.

Keywords: Case series; Ectopic pregnancy; Methotrexate; Outpatient.