Abstract
Background: Ectopic pregnancy (EP) is a common obstetric emergency, with high pregnancy related mortality in the first trimester. A major risk factor for EP is surgical procedure that may cause tubal damage and scarring. One of the most common surgery is appendectomy that may lead to adhesions and consequently an EP.
Objective: to assess the association and evidence supporting the relationship between appendectomy and EP.
Methods: An online cross-sectional case-control study was conducted among cases of women diagnosed with EP, and controls of women who had a normal pregnancy in Taif city in the period from October 2018 to October 2019. A checklist was used that included items on the participants' age, nationality, family history of EP, IUD use, pelvic intervention, pelvic infl ammatory diseases, and STDs. For study cases, items about the period between appendectomy and EP, the week of diagnosis of EP and whether treated for EP with medication or surgery were added.
Results: The mean age of the participants was (36.71 +/- 11.49) years; 11.9% had a family history of EP, 77.3% used intrauterine devices, 13.9% had a previous history of a pelvic intervention, 9.9% had a past history of pelvic infl ammatory diseases, 7.9% had a history of STDs, and 22.8% had a history of appendectomy. Cases had a significant higher percentage of those who suffered pelvic infl ammatory disease and those who had a history of appendectomy, compared to controls. Binary logistic regression found that having a history of pelvic infl ammatory diseases and a history of appendectomy were independent predictors for having EP.
Conclusion: This study calls for taking a careful history from all pregnant women to assess any risk factors of ectopic pregnancy and to provide proper management to all health problems that may be considered a risk factor of EP.