Ectopic pregnancy in New York City, 1975-1980.

Seventy-three non-federal acute care New York City hospitals were asked to report the number of ectopic pregnancies. These reports were compared with legally required certificates of termination of pregnancy (fetal death certificates). The number of ectopic pregnancies reported via the questionnaire was six times the number reported on the certificates of termination of pregnancy. Based on the hospital survey, ectopic pregnancies increased from 1,457 in 1975 to 2,080 in 1980. The number of ectopic pregnancies per 1,000 conceptions per year increased 48.5 percent, from 6.48 in 1975 to 9.62 in 1980 (p less than .001). Of the 30 fatalities related to an ectopic pregnancy, 93.4 percent were Black or Hispanic and two-thirds were single. An unexplained finding was that 75 per cent of the fatal tubal pregnancies were right-sided (p less than .01). At least one-half of the deaths were attributable to physician error and one-fifth were attributable to patient neglect. Ectopic pregnancy continues to be overlooked and misdiagnosed. Increased physician suspicion of this complication in the susceptible population is needed to decrease fatalities.