A clinical study of ectopic pregnancy in a tertiary care hospital

Abstract

Background: Ectopic pregnancy is a life-threatening emergency commonly encountered by medical practitioner. Diagnosis is frequently missed and should be considered in any women in the reproductive age group with abdominal pain or vaginal bleeding. The aim of the study is to assess the incidence, clinical presentation, risk factors, methods of diagnosis, treatment, outcome and complications.Methods: This was a prospective study at S.C.B. Medical college from January to December 2017. Parameters like age, parity, gestational period, risk factors, clinical presentations, findings on ultrasonogram and at surgery with morbidities associated with diagnosed cases of ectopic pregnancy (n=93) were noted and analysed with SPSS-19 software.Results: Incidence of ectopic pregnancy was 18/1000 deliveries. Maximum cases were in age group of 21 to 30 years (54.8 %) and parous (76.3%). Common risk factors were having history of abortions (46.2%), previous tubal sterilization (24.7%), having one or more caesarean section (17.2%) and h/o infertility (16.1%). Most common symptom was pain abdomen (96.8%). Commonest site was ampullo-isthmic region of tube and rupture was the commonest mode of presentation. All underwent laparotomy and unilateral salpingectomy was done in 86 % of cases. It contributed to 3.27 % of total maternal deaths.Conclusions: Suspicion in high risk group can direct one to investigate and diagnose early, thereby reducing morbidity, mortality and improving the prospect of future fertility.

Analysis of Ectopic Pregnancy at Paropakar Maternity and Women’s Hospital

“…6,18,22,26 Similarly, ampullary part of the tube was commonly involved in most of the ectopic pregnancies in various other studies. 13,[15][16][17][19][20][21]23,28,29 The right side was more frequent than the left which was consistent with different other studies. 16,18,21,23,26,29 Our hospital being a tertiary level referral centre, 60.2% of the women had ruptured ectopic pregnancies which is comparable to most of the studies ranging from 56% to 91.5%.…”

“…13,[15][16][17][19][20][21]23,28,29 The right side was more frequent than the left which was consistent with different other studies. 16,18,21,23,26,29 Our hospital being a tertiary level referral centre, 60.2% of the women had ruptured ectopic pregnancies which is comparable to most of the studies ranging from 56% to 91.5%. 4,13,17,19,21,26 Since most of the patients had ruptured ectopic pregnancy, they required emergency laparotomy and salpingectomy (81.8%) as life saving measures.…”

“…Similar observations were seen by Rajita et al (28%), 8 Rajendra et al (32.6%) 17 , Shraddha et al (29%), 21 Archana et al (31.2%) 22 and Arati et al (46.2%). 23 This could be due to infection following abortion causing tubal damage or dysfunction. In this study, use of medical abortion was 7.9% which is comparable to a study by Shraddha et al (9.7%).…”

Clinical presentation and outcome of ectopic pregnancy

“…Behera et al reported 54.8% in 21-30 years age group. 14 Rate of ectopic pregnancy increased with increasing age.…”

Clinical study of ectopic pregnancy at tertiary care center in Haryana, India

“…Study of Behera A et al, reported association of abortion in 46.2% and tubal ligation in 24.7% cases of ectopic pregnancy. 10 Tubal mucosal damage secondary to infection in abortion hampers the embryo transfer activity and causes ectopic pregnancy. Increased incidences of ectopic pregnancy with tubal ligation are because of the faulty technique, post-partum ligation and failure to achieve hemostasis.…”