Academic Editors: Karolina Chmaj-Wierzchowska and Katarzyna Wszołek
Background: Undiagnosed ectopic pregnancies are among the main
gynecological emergencies, and hemorrhage from an ectopic pregnancy is still the
leading cause of maternal mortality in the first trimester. During the first
lockdown period in Italy (March–April 2020) and in March 2021 restrictive
measures were issued by the Italian government, but their impact on the incidence
of ruptured tubal pregnancies remains unknown. Methods: The purpose of
this study was to evaluate the impact of restrictive measures for the COVID-19
outbreak on the incidence of ruptured tubal pregnancies at our referral center
for endoscopic gynecologic surgery. In particular, the primary outcome was the
comparison of the incidence of ruptured tubal pregnancies between the lockdown
phases and the other months of the pandemic. For this retrospective cohort study
we considered all women examined for tubal ectopic pregnancy at our emergency
unit from 1 January 2019 to 30 April 2021. We divided patients into three
groups according to the period they were referred to our center: 10 March
2019–10 March 2020 (Pre-Covid period); 11 March–4 May 2020 and 6 March–30 April 2021 (Lockdown periods); 5 May 2020–5 March 2021 (COVID-19
pandemic period without restrictive policies). We compared data acquired during
the lockdown phases with data collected both before the COVID-19 pandemic and
during the restriction-free COVID-19 period. Results: 31 of 85 women
were diagnosed with a ruptured tubal pregnancy. The proportion of ruptured
ectopic pregnancies was higher during the lockdown period than the other two
periods combined (62.5% vs 30.4%, p = 0.016). Mean gestational age and
beta-HCG levels showed the same tendency (7.31