Ectopic Pregnancy, Still A Life Threatening Emergency - A Clinical Study Of 100 Cases

Abstract

Ectopic pregnancy is still a major challenge & its incidence is on the rise due to changes in lifestyle & advances in medical practice. The objective was to study incidence, clinical presentation, risk factors & management of cases that presented in our hospital over a four -year period. A Prospective study of 100 cases presenting as ectopic pregnancy from 15-1-2010 to 15-1-2014.During this period total of 3176 deliveries & 1347 gynaecological surgeries were recorded. 100 patients had ectopic gestations accounting for 3.1% of all deliveries & 7.4% of gynaecological surgeries. Peak age group was 20-29y in 59cases(59%). Gestational age at presentation was 6-8weeks for most of the cases (62%). 59 cases (59%) were multiparous & 41(41%) were nulliparous. All had symptoms suggestive of ectopic pregnancy (amenorrhea, abdominal pain, giddiness, bleeding pervaginum). Diagnosis was confirmed by urine pregnancy test & USG. Common risk factors present were previous surgery ie LSCS-30(30%), Tubectomy-19(19%); Abortions-32(32%); Infertility-36(36%); PID-16(16%).Out of 100cases, 93 (93%) were ruptured & 7(7%) unruptured. Unruptured cases were treated medically using Methotrexate. Laparotomy was done for ruptured cases. Commonest site of Ectopic was ampulla (60%). Salpingectomy was done for most cases (73%).Although case-fatality has decreased, ruptured Ectopic gestation continues to be a common life-threatening emergency making tubal conservation inapplicable. This is of concern in a society with high premium on child-bearing.