Retrospective Study of Ectopic Pregnancy in a Teaching Hospital

Abstract

Ectopic pregnancy is the commonest cause of maternal mortality in the first trimester. There is increased incidence of ectopic pregnancy in recent times due to increased use of Assisted Reproductive Technology, early diagnosis due to ultrasonography. OBJECTIVES: To find out the incidence, various risk factors associated with ectopic pregnancy, and its outcome. MATERIAL AND METHODS: In this retrospective study 31 cases of ectopic pregnancy admitted were studied during a period of 3 years from 2011-2013 in Mandya Institute of Medical Sciences, Mandya. Various risk factors associated with ectopic pregnancy like post tubal sterilization, History of previous ectopic pregnancy, Pelvic Inflammatory Disease and tubal recanalization were analyzed among the 31 cases. Various clinical presentations based on the symptoms like pain abdomen, bleeding per vagina and site of ectopic pregnancies and its outcome like tubal rupture, tubal abortion or chronic ectopic pregnancies and its management was studied. RESULTS: There were 31 ectopic pregnancies in the study with an incidence of about 1 in 500 , ectopic pregnancies were common among the age group of 20-25 years, post tubectomy was the single most risk factor, accounting for about 35.48%, 19 cases (61.29%) presented with pain abdomen, whereas 9 cases (29.05%) had pain abdomen followed by bleeding per vagina. 58.06% of the ectopic pregnancies were ampullary pregnancies followed by 32.25% of isthmic pregnancies.25 cases (80.64%) presented with ruptured ectopic pregnancies followed by 4 (12.90%) cases of tubal abortion and 2 cases of chronic ectopic (6.45%). Salpingectomy was performed in 15 cases (48.38%) followed by salpingo-opherectomy in 12 cases (38.7%). CONCLUSION: Ectopic pregnancy still remains an important cause for maternal morbidity and mortality. However early diagnosis and early intervention depending upon the availability of facilities and skilled personnel can result in reduced morbidity and mortality.