[Ectopic pregnancy in Iceland 1985-1994.]

Ectopic pregnancy (EP) has increased during the last two-three decades and diagnostic tests and treatment have changed. Two previous studies on ectopic pregnancy have been published in Iceland. A study was initiated to evaluate changes over a new 10 year period.

All cases of histologically confirmed ectopic pregnancy during a 10 year period 1985-1994 were reviewed. Age, previous normal and ectopic pregnancies, diagnosis by ultrasound and use of intrauterine contraceptive device (IUCD), infertility problems, pelvic inflammatory disease, site of implantation and operative procedures were recorded. Rates were calculated against the background of numbers of women of reproductive age (15-44) and of pregnancies for each year and in five-year periods.

There were 1267 cases of EP with a doubling of the incidence (p for trend <0.001). There were more women of fertile age and a higher pregnancy rate in the population, but still a significant rise in incidence and prevalence above this. The age group 25-29 years was most common in 1985-1989, but 30- 34 years in 1990-1994. EP was a first pregnancy in 12.9% of cases during 1985-1989 and 15.8% in 1990- 1994. The total number of women with a previous EP rose between five-year periods. A repeated EP occurred in 16.5%, most commonly in the age 30-34 years. There were 104 women with two EPs, 44 with three, 14 with four, two with five and one each with six, seven and eight. Implantation was more often on the right side (p<0.0001). In 1.1% tuba1 sterilization had been done. Ultrasound was increasingly used as a diagnostic tool; for 68.4% of the women in the second period. Women with infertility totalled 27%. In 17% the women had an IUCD. Ovarian EP was only seen in eight cases (0.63%) and abdominal EP in two. Surgical procedures changed significantly with laparoscopic techniques being used increasingly.

The incidence of EP has increased in Iceland until in the most recent years. Treatment has changed and the need for longer hospitalisation declined.