A Clinical Analysis of Ectopic Pregnancy in an Emergency Room

ABSTRACT

The incidence of ectopic pregnancy is apparently increasing in recent years. In order to gain greater insight into the diagnosis and management of ectopic pregnancies, this study was undertaken on 100 patients with ectopic pregnancy(admitted via ER) who were operated and confirmed by histopathological study at the department of Obstetrics and Gynecology of Hallym University(Kangdong Sacred Heart Hospital) from January, 1996 to June, 1997. The results were as follows; 1. The hospital incidence of ectopic pregnancy was 1 in 11.6 deliveries(168/1954). 2. The most frequent age group was in 25-34 years of ages(58%). 3. Nullipara was 32 cases(32%) and number of cases who had 1, 2 and 3 deliveries were 35(35%), 31(31%) and 2(2%) respectively. 4. The most frequent number of pregnancy was second times(24%) and 65% of cases have been experienced artificial abortion. 5. In the past history, of possible predisposing factors, 65% had at least one abortion, 17% ectopic pregnancy, 17% cesarean section and 13% had previous laparoscopic tubal sterilization, but 19% showed no special distinct. 6. The main clinical symptoms are 96% in lower abdominal pain, 95% in amenorrhea and 65% in vaginal spotting and bleeding. 7. The most frequent interval between LMP and onset of symptoms was 6-8 weeks(49%). 8. Urine hcG test was positive in 94.9% and culdocentesis was positive in 94.3%. 9. In initial hemoglobin level, more than 11.0g% was 55%, however less than 10.0g% was 20%. 10. In initial systolic blood pressure at hospital, most of them were under normal condition, however 30% were under 90mmHg. 11. The amount of intraabdominal hemorrhage under 500cc was 42%(highest rate), 25% under 500cc-1000cc(second rate) and 6 cases overed 200cc. 12. The site of ectopic pregnancy was 88% in fallopian tube, 9% in uterine conus, 2% in intraabdomen and 1% in cervix. 13. The most common surgical procedure was ipsilateral salpingectomy(82%), of which 22 cases were operated by laparoscopy. 14. There was no fatal case in 100 ectopic pregnancy.