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A retrospective study to evaluate ectopic pregnancy in a tertiary care center

Aaliya Tabasum, Babar Rashid Zargar, Virta chauhan.




Abstract
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Background: Ectopic pregnancy is a rare but life threatening obstetrical emergency if not dealt timely. Incidence of ectopic pregnancies is on rise and this necessitates alertness about risk factors, early diagnosis and timely interventions in order to decrease subsequent morbidity and mortality.
Objective: The aim of the present study was to determine the incidence, clinical presentation, associated risk factors, treatment options, morbidity and mortality associated with ectopic pregnancy in a tertiary care center.
Methods: This retrospective observational study to evaluate ectopic pregnancy was conducted in a Tertiary Care Center over a period of one year. The clinical parameters of age, parity, gestational age, risk factors, clinical presentation, site of ectopic pregnancy, mode of treatment and morbidity & mortality were evaluated.
Results: In our study incidence of ectopic pregnancy was 1.4%, maximum between age groups of 20-30 years (71%), maximum among mutipara (55.5%). In our study associated risk factors were infertility (11.11%), PID (15.5%), tubectomy (13.3%), D&C (8.8%), Previous Ectopic (6.6%), IUCD (4.4%). 16 patients (35.5% ) had no associated risk factor. 91% patients had pain abdomen, 84% presented with amenorrhea ,66% had H/O bleeding per vaginum .73% were having ruptured ectopic pregnancy. The ectopic pregnancies were managed surgically in all patients.
Conclusion:
Although laparoscopy and medical therapy are now widely used therapeutic modalities but this choice mainly depends upon early diagnosis of ectopic pregnancy and stable condition of patient. In our study majority of cases were referred as Ruptured ectopic pregnancy so salpingectomy was the main surgical procedure done. Gynecologist should always be aware of the fact that in any women of reproductive age group presenting with complaint of pain lower abdomen, diagnosis of ectopic pregnancy should be kept in mind irrespective of the presence or absence of amenorrhea, whether or not women has undergone sterilization in order to improve prognosis of patients in terms of fertility, morbidity and mortality.

Key words: Amenorrhea, Ruptured ectopic pregnancy, risk factors, salpingectomy






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