An 'epidemic' of ectopic pregnancy in West Hertfordshire, UK?

Our clinical impression is that the incidence of ectopic pregnancy in West Hertfordshire in the UK has been steadily rising to almost 'epidemic' proportions. On the basis of our clinical suspicion, a retrospective study was performed looking at the ectopic pregnancy rates in the region from 1993 to 2007. All histologically proven ectopic pregnancies were obtained using the hospital histology database and all deliveries (live births and stillbirths) were obtained using the Ciconia Maternity information System (CMiS). The numbers of legal terminations of pregnancy (NHS and non-NHS) as well as women of reproductive age were obtained using the databases from the Office for National Statistics and Department of Health. In terms of absolute numbers of histologically proven ectopic pregnancies, there were 38 cases in 1993, rising to a peak of 68 cases in 1998 and 59 cases in 2007. This equates to 6.5/1,000 deliveries in 1993, 11/1,000 deliveries in 1998 and 10.7/1,000 deliveries in 2007. Although there have been fluctuations in ectopic pregnancy rates over 15 years, this did not reach statistical significance. Therefore, contrary to our clinical suspicion, the incidence of ectopic pregnancy in West Hertfordshire has remained stable.