- Members of the ectopic pregnancy foundation have undertaken research into various aspects of ectopic pregnancy. This include aetiology, trends in rates, and new methods of expressing rates. Also a number of case reports on ectopic pregnancy including the first reported case of two ectopic pregnancies in consecutive menstrual cycles’ and a one in 10 26 This reaserch has led to a number of publications in peer reviewed journals These publications are referenced below in chronical order with the most recient first
- De Rosnay P, Irvine LM. 2012. Reporting rates of ectopic pregnancy: Are we any closer to achieving consensus? Journal of Obstetrics and Gynaecology; Vol. 32, No. 1, Pages 64-6
- De Rosnay P, Irvine LM. 2010. An ‘epidemic' of ectopic pregnancy in West Hertfordshire, UK? Journal of Obstetrics and Gynaecology 30:179-183.
- Irvine LM, Setchell ME. 2009. Ectopic pregnancy: a 1 in 1.4 x 10(8) patient. J Obstet Gynaecol. Jul;29(5):448-9.
- Salman G, Irvine LM. 2008. Ectopic pregnancy, the need for standardisation of rate. Journal of Obstetrics and Gynaecology 28:32-35.
- Azizia M, Phadnis S, Irvine LM. 2006. Surgical management of ectopic pregnancy in a district general hospital. J Obstet Gynaecol. 2006 Oct;26(7):656-62.
- Irvine LM. 2006. Ruptured ectopic pregnancy after a decline in chorionic gonadotropin. J R Soc Med.; 99(2): 90.
- Irvine LM, Setchell ME. 2001. Declining incidence of ectopic pregnancy in a UK city health district between 1990 and 1999. Human Reproduction 16:2230-2234.
- Irvine LM, Padwick PM. 2000. Serial serum HCG measurements in a patient with an Ectopic pregnancy: A case for caution; Human Reproduction vol.15 no 7 pp. 1646-1647
- Irvine LM, Hicks JL, Blair-Bell C, Setchell ME. 1994. The incidence of ectopic pregnancy in the City and Hackney Health District of London. J. Obstet. Gynaecol 14:29-34
The incidence of ectopic pregnancy in the City and Hackney Health District of London, 1990 - 1991
L.M.Irvine, Jo L Hicks, Caroline Blair-Bell and M.E. Setchell
Department of Obstetrics and Gynaecology, and Medical College of St Bartholomew's Hospital, London
In a retrospective study in the City and Hackney Health District, between 1 September 1990 and 31 August 1991, there were 106 ectopic pregnancies, 474 histologically confirmed spontaneous pregnancy failures, 2244 legal abortions and 4047 deliveries. The incidence of ectopic gestation was 1.54% of all known pregnancies, 2.62% of all deliveries and 2-13/1000 per year of all women of childbearing age. These rates are among the highest reported in the world literature.
There was a greater percentage of Afro-Caribbeans in the ectopic pregnancy patients (56.8%, compared with 34.5% in a control group, P < 0.001), and the patients with ectopic pregnancies were more likely to have had suction terminations of pregnancy - 30.8%, compared with 12.5% of the controls (P < 0.001). Previous ectopic pregnancy was more common in the ectopic pregnancy group, 9.9% versus 2.0% in controls (P < 0.05%).
Journal of Obstetrics and Gynaecology (1994) 14, 29-34
Declining incidence of ectopic pregnancy in a UK city health district between 1990 and 1999
L.M.Irvine, and M.E.Setchell
Watford General Hospital, Vicarage Road, Herts WD18 OHB and The Whittington Hospital, Highgate Hill, London N19 5NF,UK.
On the basis of clinical impression that the number of cases of ectopic pregnancy seen in the City and Hackney Health District, London, was changing, a retrospective study of the years between 1990 and 1999 was carried out. METHODS: From the histopathology databases, cases of ectopic pregnancy and early pregnancy failure were identified. The number of deliveries at The Homerton Hospital was obtained from the Labour Ward register; the number of terminations of pregnancy and the number of fertile women was obtained from the Office for National Statistics; UK. RESULTS: There were 73 cases of ectopic pregnancy in 1990 rising to 96 in 1991 and then a fall to 52 cases in 1999. In terms of ectopic pregnancy per 100 deliveries, per all known pregnancies and per 1000 fertile women per year, there was a peak in 1991 and a fall to 1999. With regard to relative incidence per deliveries and per all known pregnancies, these falls were significant (P < 0.05). In 1991, there were 2.4 ectopic pregnancies per 100 deliveries, falling to 1.6 in 1999, a 33% fall. The reasons for this large decline are uncertain. CONCLUSIONS: There has been no change in patient population, diagnostic aids used or management protocols for patients with ectopic pregnancies.
Key words: ectopic pregnancy/relative incidence changes
Serial serum HCG measurements in a patient with an Ectopic pregnancy: A case for caution
Laurie Montgomery Irvine and Malcolm L.Padwick
Consultant Gynaecologists, Department of Obstetrics and Gynaecology, Watford General Hospital, Vicarage Road, Watford, Herts WD180HB,
Improvements in the use of ultrasound in early pregnancy have resulted in improved diagnosis of miscarriage and ectopic pregnancy. There are still, however, a significant number of women with a suspected abnormal pregnancy, where transvaginal ultrasound is unable to locate the pregnancy. The concern is the possibility of ectopic pregnancy. An alternative diagnostic tool is required and it has been suggested that it is possible to monitor serum B human chorionic gonadotrophin. The present case highlights the potential dangers of this management.
Key words: ectopic pregnancy/serial serum B HCG measurements/tubal rupture.
Human Reproduction vol.15 no 7 pp. 1646-1647, 2000
J Obstet Gynaecol. 2006 Oct;26(7):656-62.
Surgical management of ectopic pregnancy in a district general hospital.
Azizia M, Phadnis S, Irvine LM.
Department of Obstetrics and Gynaecology, Watford General Hospital, Watford, UK.
The mainstay of management of ectopic pregnancies is laparoscopic surgery. Other treatment options include open laparotomy, methotrexate or expectant approach. Recently the Royal College of Obstetricians and Gynaecologists (RCOG) revised its guidelines regarding management of suspected ectopic pregnancies. We undertook a retrospective study looking at management of ectopic pregnancies over a defined 12-month period (1 October 2003 - 30 September 2004) in a district general hospital to the north of London and compared this with the recommended RCOG guidelines 2004. Cases of ectopic pregnancy were identified from the theatre, ward log, and cross-referenced with histopathological reports. The case notes of these women were reviewed and data extracted according to a drawn-up questionnaire. A total of 64 cases met the diagnostic criteria and were included in the study. Nine of the 64 cases were haemodynamically unstable and seven underwent rapid laparotomy. All of the stable 55 cases underwent laparoscopy, which was converted to open laparotomy in 13 cases (23.6%). Three patients were treated with methotrexate all of whom had been previously managed surgically. The majority of cases of ectopic pregnancy were managed according to the RCOG recommendations. Further changes in practice will be required to incorporate expectant and primary medical management as proposed by the recent guidelines (RCOG 2004). This study reveals progress achieved in management of ectopic pregnancies in UK with the introduction of RCOG guidelines 1999.