Authors & Affiliations:
 Ky’Tavia Stafford-Carreker, MS3 (1,2), Margaret English, MD (2), Jamie Woodley, MD (2), Nuriya Robinson, MD (2)
(1) Department of Family Medicine at UCLA; (2) Department of Obstetrics and Gynecology, UCLA – Harbor-UCLA Medical Center

Introduction

 Ectopic pregnancy (EP) is a serious condition where a fertilized egg implants outside the uterus, most often in the fallopian tube. Without prompt treatment, it can rupture and lead to a life-threatening hemorrhage. It remains a leading cause of first-trimester maternal mortality. Most patients present to the ED with abdominal pain, vaginal bleeding, or syncope. This study examines how race and insurance status impact EP management at Harbor-UCLA, a high-volume safety-net hospital serving most underrepresented in Medicine (UIM) populations, where delayed care can increase complications and mortality risk.

Methods
             We conducted a retrospective chart review of 39 patients diagnosed with ectopic pregnancy at Harbor-UCLA Medical Center from January 2020 to December 2022 under IRB approval #22-001671. We collected demographic data (race/ethnicity, insurance), clinical presentation (symptoms, β-hCG, imaging), treatment type (methotrexate vs. surgery), diagnostic delays, morbidity, and documented social determinants of health (SDOH). ACOG and institutional algorithms assessed treatment eligibility based on hemodynamic stability, β-hCG levels, ultrasound findings, and contraindications. Descriptive statistics and chi-square tests were used. Logistic regression is planned to adjust for confounders.

Results
            A preliminary analysis of 39 charts revealed racial and insurance-based disparities in EP care. Black and Latinx patients more frequently presented with signs of rupture and higher β-hCG levels. They were more likely to undergo surgical management than white patients, even when eligible for methotrexate. Medi-Cal patients were also less likely to receive methotrexate than those with private insurance. Limited documentation of SDOH and delayed recognition may contribute to these inequities. Multivariate analysis is underway to evaluate whether disparities persist after adjusting for clinical and structural factors.

Conclusion
             Our findings highlight disparities in ectopic pregnancy care among historically excluded populations at a public hospital. Even when meeting the criteria for medical management, Black and Latinx patients were more likely to undergo surgery. These trends reflect broader systemic barriers in reproductive care. Improving early diagnosis, consistent use of treatment algorithms, and robust SDOH screening in the ED and clinic settings may help reduce preventable complications and advance equity in early pregnancy outcomes.