ABSTRACT
Objective: To analyze risk factors and impact of diagnostic delays on presentation and management of ectopic pregnancy
Study design: Descriptive case series
Place and Duration of Study: Department of Obstetrics and Gynecology Unit- I, Sir Ganga Ram Hospital [SGRH] and Nawaz Sharif Social Security Hospital Lahore, from January 2012 to June 2013
Methodology: Women diagnosed with ectopic pregnancy were included in the study. Data was reviewed from the charts of all patients diagnosed with ectopic pregnancy through structured proforma. The variables studied included age, parity; symptoms and signs, risk factors, treatment and associated delays contributing to increased morbidity
Results: Total number of patients studied were 100. The peak age of ectopic pregnancy was between 21 to 30 year. It was found more in primigravida [n=60 - 60%]. The common identifiable risk factors were previous cesarean section [n=30 - 30%], infertility [n=25 - 25%], pelvic inflammatory disease [n=25 - 25%] and history of previous ectopic pregnancy [n=6 - 6%]. Phase I delay was present in 30 [30%] patients while same number of women experienced delay in proper referral. In 20 cases [20%] phase III delay was noted at hospital level. Most of the patients presented with abdominal pain [n=90 - 90%], pallor [n=80 - 80%] and features of shock [n=40 - 40%]. Ultrasound [US] confirmed diagnosis in 60 [60%] cases. In 95 [95%] patients it was of tubal variety out of which 70 [70%] were already ruptured. Salpingectomy was performed in 88 [88%] patients. There was no mortality in this series
Conclusions: The clinical presentation in most of the cases was different from usual resulting in delay in diagnosis. Majority of the patients required laparotomy and salpingectomy was performed in 88% patients