Ectopic Pregnancy: A Single Tertiary Centre Experience

ABSTRACT

Background: EP is an unmitigated disaster of human reproduction, a major cause of reduced childbearing potential. EP can occur in Fallopian tubes, ovaries, cervix, abdominal cavity, cornua of uterus and c- section scar. But 95-98% of ectopic pregnancies are tubal. Aim: To study incidence, risk factors, clinical presentation immediate morbidity and mortality associated with ectopic pregnancy. Materials and methods: Patients diagnosed with ectopic pregnancy in reproductive age group (15-44 years) after clinical examination and investigations during one year period were included in the study. It was prospective study. Data was entered in MS excel spreadsheet and analyzed. Results: A total of 70 cases of ectopic pregnancy were included. Incidence of ectopic pregnancy in the present study was 7.6 per 1000 deliveries. Mean age was found to be 28 years and majority of them were multi gravida (93.3%) with low socioeconomic background (92.9%). Most common clinical presentation was a combination of amenorrhea (95.7%) and pain abdomen (100%). Bleeding per vagina was also seen in 28.6% of cases Past history of tubectomy was present in 24.3% of cases. Clinical signs such as abdominal tenderness, distension and guarding were noted in 75%, 88%, 75% of tubal rupture as compared to 25.7%, 12% and 25% of unruptured ectopic pregnancy. Cases of ruptured ectopic pregnancy presented with severe pallor (81.8%) and shock (100%). Urine pregnancy test was positive in all cases. Ultrasonography was an accurate tool for diagnosis and differentiated ruptured (74.3%) from unruptured (25.7%) ectopic pregnancies. Emergency laparotomy and salpingectomy (91.4%) on affected side was the treatment in majority of cases. Conclusion: Ectopic pregnancy is an important cause of maternal morbidity and mortality, high index of clinical suspicion, positive urine pregnancy test, ultrasonographic features point to early and accurate diagnosis of this entity. Treatment in time may save many lives and decrease associated morbidity.