Objectives
The current coronavirus (COVID‐19) pandemic has become an unprecedented global public health emergency. This has had an impact on early pregnancy care provision with the rationalisation of services to maintain a safe clinical environment for patients and healthcare professionals. Our aim is to assess the treatment and outcomes for miscarriage and ectopic pregnancy during COVID‐19 compared to the same time period before the pandemic.
Methods
Data from a single site dedicated maternity hospital in the UK was collected retrospectively. All women with a final diagnosis of miscarriage and ectopic pregnancy were identified. The data collection period was during the UK “lockdown” period from 23.03.20 to 07.06.20. This will be compared to data collected from 2019.
Results
In this study, we compare the efficiency and safety of early pregnancy protocols implemented during COVID‐19 on the treatment and outcomes for women diagnosed with miscarriage and ectopic pregnancy. We use a number of different criteria to measure efficiency and safety including primary and subsequent treatment, number of post‐diagnosis visits to hospital and unscheduled or emergency admissions. The evolving pandemic and recent easing of lockdown restrictions means the 30‐day outcome data is still awaited before analysis can be completed.
Conclusions
In line with RCOG and ISUOG guidance, adaptations were made to early pregnancy protocols with a more conservative approach adopted. The aim was to streamline patient visits while ensuring women were safely being cared for. This included the increased use of telephone triage, remote follow‐up, increased outpatient medical management of miscarriage as well as the use of manual vacuum aspiration under local anesthesia where appropriate. For ectopic pregnancy, we followed the joint RCOG/BSGE guidance to reserve laparoscopy if the alternate conservative or medical management options were not viable due to the initial concerns around laparoscopy being aerosol‐generating. This pandemic has given us an opportunity to reflect on the safety and efficacy of practice.