Analysis of tubal pregnancy

ABSTRACT

This study was carried out to determine the frequency, etiological factors, modes of presentation, accuracy of diagnostic modalities, operative findings and surgical treatment of tubal pregnancies. Design: Observational study. Place and Duration of Study This study was conducted in gynae unit III, Sir Ganga Ram Hospital, Lahore from January 1995 to December 1996. Subjects and All the patients diagnosed as a case of tubal pregnancy in two years period were included in the study. Detailed history regarding the symptoms and risk factors of tubal pregnancy was taken followed by clinical examination. The diagnostic and treatment modality used and operative findings were also recorded. All the data was recorded on a proforma and finally the results were analysed. Incidence of tubal pregnancy was found out to be 1305 deliveries. Out of these, 70% of the cases occurred in the age group of 21-30 years and in patients with low parity [in para 0-2] 65% of the patients had high risk factor e.g. previous abdominopelvic surgery PID or history of infertility. Pain was the commonest symptom [90% of cases] followed by vaginal bleeding [80%] adnexal masses [70%] and amenorrhea [65%]. Acute tubal pregnancy was found in 85% of the cases while 15% of cases had chronic tubal pregnancy. Tubal pregnancy in the ampullary region was detected in 65% patients. Previous abdominopelvic surgery, PID, history of infertility and use of intra-uterine contraceptive device are the main etiologic factors. Most of the patients present at a very late stage with ruptured tubal pregnancy followed by salpingostomy in 95% of cases. Only 5% of cases had conservative surgical treatment i.e. salpingostomy. Culdocentesis ultrasonography and laparoscopy were good diagnostic modalities