Presentation and management of ectopic pregnancy in a tertiary care teaching hospital

ABSTRACT

To identify risk factors, presentation, correlation between clinical signs, symptoms and final diagnosis and treatment of ectopic pregnancy. A cross sectional analytical study. This study was conducted at DHQ Hospital Faisalabad over a period of one year, from January 2004 to January 2005. All the patients, with suspicion of ectopic pregnancy by their presentation, underlying risk factors, were admitted through emergency and gynaecology out patient department. Initial diagnosis of ectopic pregnancy was made in patients presented with amenorrhoea, abdominal pain and irregular bleeding. Ultrasound and urine for pregnancy test were done for confirmation of diagnosis. Any underlying risk factors for ectopic pregnancy were also recorded. A total of 24 cases of ectopic pregnancy were managed during study period. Initial diagnosis was correct in 18 patients [75%], while 6 patients [25%] were assigned a different diagnosis on admission. The highest percentage of patients 66.6% [16 cases with ectopic pregnancy were between the age of 30-35 years. 6[25%] patients were nullipara and 18 [75%], were multiparos. 16[66.6%] of patients had underling risk factors for ectopic pregnancy, while no risk factor was detected in 8[33.3%] patients. The most frequently experienced symptoms of ectopic pregnancy were abdominal pain [66.6%], amenorrhoea [58.3%] and vaginal bleeding [41.6%]. Salpingectomy through laparotomy was done in all cases. No patients qualified for expectant or medical treatments because of late presentation and rupture of the tube beyond the scope of repair. The mortality was nil because of effective resuscitative measures and immediate surgical correction