Ectopic pregnancy rate and treatment utilization in a large managed care organization

OBJECTIVE: To estimate die ectopic pregnancy rate at Kaiser Permanente, Northern California, during 1997-2000. METHODS: Computerized data systems covering inpatient, outpatient, and pharmacy records were reviewed for evidence of ectopic pregnancies during the study period. Denominator data were calculated from computerized utilization and membership data for the same period. RESULTS: We identified 2,617 ectopic pregnancies that occurred between 1997 and 2000 among 126,451 reported pregnancies for an annual rate of 20.70 per 1,000 reported pregnancies and 1.03 per 1,000 women 15-44 years old. There was no evidence of a trend over time in these data. The rate increased with increasing age. Approximately 35% of these women were medically treated, and we observed an increase over time in the proportion of women who were medically treated. CONCLUSION: Using computerized data systems in a large integrated health delivery system, we found that the rate of ectopic pregnancy in 1997-2000 was similar to the national rate in 1990 -1992, when national data were last available. These data suggest that the ectopic pregnancy rate is not increasing, although differences in the study populations need to be kept in mind. Medical treatment seems to be increasing over time. (Obstet Gynecol 2005;105:1052-7. (c) 2005 by The American College of Obstetricians and Gynecologists).