Clinical profile and outcome of ectopic pregnancy in tertiary care hospital

Abstract

Introduction: Ectopic pregnancy is a common life-threatening gynaecological surgical emergency. Its incidence is rising globally and remains a major cause of morbidity and mortality in early pregnancy. The present study is aimed to determine clinical profile and outcome of ectopic pregnancies in a tertiary care teaching hospital. Methods: After protocol review committee and institutional ethics committee permission, this prospective observational study was conducted in the OBG department of Dr Rajendra Prasad Government Medical College in Tanda on pregnant women in their first trimester with ectopic pregnancy characteristics and diagnosis. The study covered all prenatal clinic and labor room patients who met the selection criteria from February 2020 to January 2021. Results: The most common USG finding of adnexal ectopic mass was detected in 97.2% (70 cases), out of which adnexal mass with mild free fluid in the pouch of Douglas on TVS was detected in 77.7% (56 cases). The presence of fluid in peritoneal cavity (Morrison pouch on TAS) indicating severe hemoperitoneum was detected in 20.8% (15 cases). Most common site of ectopic pregnancy was in the tubal ampullary region in i.e., 45.5% (30 cases), followed by isthmus 18.2% (12 cases), fimbria end of the tube 10.6% (7 cases) and isthmus-ampullary region in 10.6% (7 cases). Medically managed patients were 15.2% (10 cases) & their exact site of tubal ectopic was not known. The patients who were presented with ruptured tubal ectopic pregnancy were 63.6% (42 cases), unruptured tubal ectopic were 21.2% (14 cases), chronic ectopic were 7.5% (5 cases) and tubal abortion were 6.06% (4 cases). Conclusion: Ectopic pregnancies are common and deadly gynecological emergencies. Late diagnosis and referral cause high ruptured ectopic pregnancy rates in developing nations.