RESUMO
To determine the clinical presentations and the management options for ectopic pregnancy. Descriptive study. Department of Obstetrics and Gynecology Liaquat National Hospital Karachi, from 13[th] August 2011 to 12[th] August 2012. A total of 40 cases diagnosed with ectopic gestation were included in this study. Information was retrieved from the case notes and labor ward registers. The data was analyzed with simple descriptive statistics. During the study period the total number of gynecological admissions were 1126 and 1618 deliveries conducted. Forty patients had ectopic gestations accounting for 2.4% of all deliveries and 3.5% of all gynecological admissions. The peak age group was 20-30 year [62.5%]; 95% [n=38] were married. Cases of ectopic pregnancy found more in primigravida 45% [n=18] patients. Abdominal pain was the most common presenting symptom in 92.5% [n=37] of patients whereas history of amenorrhea present in 75% and vaginal bleeding was found in 45% of patients. Commonest clinical sign was cervical excitation present in 82%. Identifiable risk factors were present in 52.5% of cases, the most frequent being previous miscarriages in 22.5%. Surgical management was done in 95% patients while 5% managed medically. Ruptured ectopic pregnancy was seen in 85%. Tubal ectopic pregnancy was present in 92.5% [n=37], ovarian 2.5%, and heterotopic pregnancy in 2.5%. Salpingectomy was performed in 89% while salpingotomy done in 7.8% cases. Hysterectomy was done in one patient. Blood was transfused in 75% [n=30] patients. There was no maternal death related to ectopic pregnancy. Ectopic pregnancy was found more in primigravida. Abdominal pain was the single most consistent feature of ectopic pregnancy. Most cases presented late making tubal conservation treatment inapplicable.