HIGHLIGHTS FROM THE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE’S 2021 SCIENTIFIC CONGRESS
Compared to white women, Black and Hispanic women were more likely to have their ectopic pregnancies treated with “open” surgery rather than the laparoscopic (minimally invasive) approach from 2010-2019. For this study, researchers evaluated data from the American College of Surgeons’ National Surgical Quality Improvement Program.
Of the 9,164 patients undergoing surgical management of a tubal ectopic pregnancy, 85% underwent laparoscopic surgery while 14% had open surgery, which requires a longer recovery time. The researchers found that Black and Hispanic women had greater odds of undergoing the open surgery. That trend was consistent throughout the study period, although from 2010 to 2019, the laparoscopic approach increased in use from 80.8% to 90.8%.
The data also revealed that Black and Hispanic patients were more likely to have their ectopic pregnancies treated with salpingectomy, which is surgical removal of one or both fallopian tubes rather than salpingostomy, a surgical unblocking of the tube. The study offers no reasons for the disparities.
Ectopic, or tubal pregnancy is caused when a fertilized egg lodges in a fallopian tube instead of continuing its journey to the uterus. When that happens, the fertilized egg cannot survive. Yet as it grows, it can cause the tube to rupture, threatening the life of the woman, so immediate surgical treatment, whether laparoscopic or open surgery is needed.
“As more and more states pass abortion bans which would also outlaw appropriate treatment of ectopic pregnancies, we see yet again how these measures can have a disproportionate impact on women of color. These restrictions are unconscionable and we at ASRM will continue to use research like this to make the case to stop them,” said Marcelle Cedars, M.D., President-elect of the American Society for Reproductive Medicine.
O-4, A. Huttler et al, DISPARITIES IN SURGICAL MANAGEMENT OF TUBAL ECTOPIC PREGNANCY