Dooley W M, Farren J, De Braud L V, Solangon S A, Thanatsis N, Al Wattar B H, Jurkovic D
EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London (UCL), London, UK.
Beginning Assisted Conception Unit, Epsom and St Helier University Hospitals, London, UK.
Ultrasound Obstet Gynecol. 2025 Jul;66(1):89-95. doi: 10.1002/uog.29262. Epub 2025 Jun 5.
To assess the effect of interpregnancy interval on the odds of recurrence of tubal ectopic pregnancy (TEP) following expectant or surgical management.
This was a retrospective cohort study conducted at a tertiary early pregnancy unit (EPU) in London, UK. Patients diagnosed with TEP following spontaneous conception, who had expectant or surgical management and who attended the EPU between December 2008 and January 2021 were included. Univariate and multivariate regression analyses were conducted to explore the association between the odds of recurrence of ectopic pregnancy and various factors, including maternal history, interpregnancy interval and management method of the index TEP, and analyses were adjusted for confounders. The main outcome measure was the odds of recurrence of extrauterine ectopic pregnancy in women presenting with a subsequent pregnancy.
A total of 1386 women with TEP were included, of whom 626 (45.2%) presented with a subsequent pregnancy. Fifty-nine of these women were excluded, as their subsequent pregnancy was conceived via in-vitro fertilization. From the remaining 567 women, 59 (10.4%) were diagnosed with recurrent extrauterine ectopic pregnancy. An interpregnancy interval of 6-18 months was associated with four times the odds of recurrence compared with an interval of ≤ 3 months (odds ratio (OR), 4.05 (95% CI, 1.37-12.03)). Women with two or more previous TEPs had more than three times the odds of recurrence compared to those with one previous TEP (OR, 3.27 (95% CI, 1.13-9.42)). Surgical management of the index TEP was associated with similar odds of recurrence as expectant management (OR, 1.26 (95% CI, 0.72-2.20)).
Rapid conception after TEP is associated with low odds of recurrence. Therefore, purposeful delay to conception after TEP, including those managed expectantly, should not be recommended. Women with conception delay or a history of more than one ectopic pregnancy are at high risk of recurrent extrauterine ectopic pregnancy. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
评估妊娠间隔对期待治疗或手术治疗后输卵管异位妊娠（TEP）复发几率的影响。
这是一项在英国伦敦一家三级早孕单元（EPU）进行的回顾性队列研究。纳入2008年12月至2021年1月期间在该EPU就诊、经自然受孕诊断为TEP且接受期待治疗或手术治疗的患者。进行单因素和多因素回归分析，以探讨异位妊娠复发几率与各种因素之间的关联，这些因素包括母亲病史、妊娠间隔以及首次TEP的治疗方法，并对混杂因素进行了校正。主要结局指标是后续妊娠女性发生宫外异位妊娠复发的几率。
共纳入1386例TEP女性患者，其中626例（45.2%）有后续妊娠。其中59例女性被排除，因为她们的后续妊娠是通过体外受精受孕的。在其余567例女性中，59例（10.4%）被诊断为宫外异位妊娠复发。与间隔≤3个月相比，妊娠间隔6 - 18个月的复发几率高出四倍（比值比（OR），4.05（95%置信区间，1.37 - 12.03））。有两次或更多次既往TEP的女性复发几率是有一次既往TEP女性的三倍多（OR，3.27（95%置信区间，1.13 - 9.42））。首次TEP的手术治疗与期待治疗的复发几率相似（OR，1.26（95%置信区间，0.72 - 2.20））。
TEP后快速受孕与复发几率较低相关。因此，不建议对TEP后受孕进行刻意延迟，包括那些接受期待治疗的患者。受孕延迟或有不止一次异位妊娠史的女性发生宫外异位妊娠复发的风险较高。© 2025作者。《妇产科超声》由约翰·威利父子有限公司代表国际妇产科超声学会出版。
