A prospective clinical study of ectopic pregnancy at a tertiary care hospital, Shillong, Meghalaya

Abstract

Background: Ectopic pregnancy is one of the commonest cause of acute abdominal emergencies in obstetric practise with a case fatality rate of 1-3 % in developing countries. Therefore, it is imperative to diagnose the unruptured ectopic pregnancy to prevent morbidity and mortality Materials and Methodology: This was a prospective observational study of 1 year with the sample size of 44 cases out of 976 newly diagnosed first trimester pregnancies. Results: The incidence was found to be 4.5 % with the majority of a cases belonging to the age group of 31-34 years and lower socioeconomic class. Clinical presentation was mostly between gestational age 4-8 weeks with 70.5% being multigravida. Out of all risk factors, history of previous abortion was found to be most common. Most common presentation of the cases was pain abdomen. Out of all 79.5% cases were ruptured and 20.5% were unruptured. Ampullary region was the commonest site and majority of the cases were managed laparoscopically. Conclusions: Ectopic pregnancy is still major challenge because of its bizarre clinical presentation. Early diagnosis and timely intervention are the key factor for prevention of mortality and morbidity. Therefore, strong suspicion and multidisciplinary approach with blood transfusion facilities and early tertiary care referral will go a long way to prevent morbidity and mortality.

To determine the burden of ectopic pregnancy in the tertiary care centre (TRIHMS) of Arunachal Pradesh and its implication on the type of surgical and anaesthetic management

“…2 Studies suggest rising trend in cases of ectopic pregnancy due to better and sensitive diagnosis facility. 3,11,12 In our study we found incidence rate of EP to be 22.9 per 1000 deliveries or 2.29 %, which is higher than the national incidence as well the incidence reported in north-eastern part of India. 11,13 But our finding was lower than study of Ranji GG et al 14 who reported occurrence of EP to be 2.81% where she included cases which were manage medically as well as surgically.…”

“…3,11,12 In our study we found incidence rate of EP to be 22.9 per 1000 deliveries or 2.29 %, which is higher than the national incidence as well the incidence reported in north-eastern part of India. 11,13 But our finding was lower than study of Ranji GG et al 14 who reported occurrence of EP to be 2.81% where she included cases which were manage medically as well as surgically. However the mortality rate in this study was 1.2% which is comparable to national mortality rate of ≤ 3.5%.…”