A study on risk factors and clinical presentation of ectopic pregnancy

Abstract

Objectives: The present study was designed to study the risk factors of ectopic pregnancy and their clinical presentation. Material and methods: It was a retrospective study with 100 cases of ectopic pregnancy conducted in the Department of Obstetrics and Gynecology, ESIC MC PGIMSR, Rajajinagar, Banglore for a period of 2 years were included. Detailed history suggestive of risk factors for ectopic pregnancy, menstrual and obstetric history was taken. Results: A total of 7200 pregnancies were confirmed during the study period, of which 100 cases of ectopic pregnancies were diagnosed, giving an incidence of 1.38%. Sixty three percent were in the age group of 21-30 years. Seventy six percent of women were multigravidae. Forty eight percent of the patients had identifiable risk factors, of which past history of pelvic inflammatory disease in 28%, history of previous abortion in 16%, infertility in 10%, history of previous ectopic pregnancy in 14%, history of previous caesarian section in 18% and tubectomy in 14% were noted. Ninety six percent had amenorrhea, followed by pain abdomen in 88%, bleeding per vagina in 78%, fainting and syncopal attack in 16% of the patients. Pallor in 56% of the cases, 10% presented with shock. Conclusion: The early diagnosis of an ectopic pregnancy is one of the greatest challenges for a physician. It requires a high index of suspicion in case of clinical presentation of pain abdomen, bleeding per vagina with amenorrhoea. The importance of an early diagnosis lies in the fact that the patient can be offered a conservative line of management which can definitely have a beneficial effect on her future fertility.

Clinical Profile, Risk Factors and Outcomes of Ectopic Pregnancy in a Tertiary Care Hospital: A Prospective Indian Study

“…The present study reports a frequency of 75 patients with ectopic pregnancy (5.5%). In comparison, in an Indian study by Prasanna et al [ 7 ], the frequency of EP was 1.8%, while another Indian study by Nethra et al [ 6 ] reports a frequency of 1.38%. Verma et al [ 2 ] reported frequency of EP to be 2.3%.…”

“…The most common symptom was pain in the abdomen (90.76%), amenorrhea in 79.23% of cases, and bleeding PV in 63.07% of cases. Nethra et al [ 6 ] reported that the majority of women were 21-30 years of age (63%), were multigravida (76%), and had lower socioeconomic status (74%). Amenorrhea, pain in the abdomen, bleeding per vagina, and fainting and syncopal attack were present in 96%, 88%, 78%, and 16% cases, respectively.…”

“…The study by Kalyankar et al [ 5 ] also observed PID to be the most common risk factor (17.69%), with other factors being infertility (10.76%) abortion and dilation and curettage (D&C) (12.30%), previous ectopic (6.15%), sterilization (17.69%) and IUCD use (2.30%). Nethra et al [ 6 ] observed that a history of PID was present in 28% of the patients. History of prior abortion was seen in 16% of cases.…”

“…EP can occur due to poor surgical technique and the development of peritubal fistulas. Edematous, congested, and friable tubes in the postpartum period enhance the risk of incomplete tubal occlusion leading to EP [ 6 , 7 ].…”

“…The EP spectrum includes asymptomatic patients as well as ruptured ones that present in shock. Increased morbidity and occasionally even fatality are consequences of delayed diagnosis [ 6 ]. It could even have an impact on her future fertility if not treated instantly and effectively [ 7 ].…”