A clinical study of the incidence, management and outcome of ectopic pregnancy

Abstract

Background: Ectopic pregnancy is one of the most dreaded complications of early pregnancy which risks the life of young women. However, in the present scenario, with better health care facilities, maternal mortality has been reduced drastically; it still remains a matter of concern in third world countries. Methods: This prospective study was conducted in the department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College Kangra at Tanda, Himachal Pradesh after all ethical permissions, to study the incidence, management and outcome of ectopic pregnancy. 98 women, who were diagnosed as having ectopic gestation, were enrolled for the study after their informed consent. Results: In the present study, the incidence of ectopic pregnancy was 9.1 per thousand deliveries. 58.16% of the patients presented at the gestational age of 6-8 weeks. History of abdominal and pelvic surgery (30.61%) and infertility (22.45%) were the most common associated risk factors. The typical triad of amenorrhea, pain abdomen and bleeding was observed in 40% of cases. 7.95% of the patients were severely anemic and 5 patients presented with shock. Adnexal tenderness was the most common sign elicited clinically (84.69%), whereas, complex adnexal mass was confirmed in 96.93% of the patients on sonography. 84.69%, 16.32% and 1.02% of the total patients were managed with surgical, medical and expectant treatment respectively. The most common procedure performed was unilateral salpingectomy in 75.56% of the patients. 76.53% of the cases required blood transfusion for resuscitation in their operative and postoperative period and 8 patients needed ICU admission. There was no maternal mortality in the current study. Conclusion: Rising incidence rates of ectopic pregnancy should alert gynecologist in general, efforts should be made for early diagnosis of ectopic pregnancy and timely referral to reduce maternal morbidity and mortality.