A clinic-demographic study of incidence of ectopic pregnancy and its management

Abstract

Aim: To determine the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies. Methods: This observational study was carried out in the Department of Obstetrics and Gynaecology, Narayan Medical College and Hospital, Jamuhar, Sasaram, Bihar, India from Jan 2018 to Dec 2018. Total 120 cases were diagnosed with ectopic pregnancy. Results: the incidence of ectopic pregnancy was 6.1per 1000 deliveries. Majority of the patients 61 (50.83%) belonged to 20-25 years. 83.33% of the patients were ≤ 30 years. Most of the patients 72 (60%) belonged to lower class socioeconomic status. Majority of the patients 89 (74.17%) were multiparous. The most common site of ectopic pregnancy was fallopian tube 109 (90.84%). The most common risk factor was pelvic inflammatory disease 52 (43.33%) followed by H/o previous abortion 27(22.5%) and H/o previous abdominopelvic surgery including tubal ligation, LSCS and appendicectomy 16(13.33%). Almost 97.5% patients in our study came with history of variable period of amenorrhoea. 106 (88.33%) cases complained of abdominal pain. 66.67% of the patients had bleeding or spotting per vaginum. All the patients with ectopic pregnancy were managed surgically. 95% patients underwent laparotomy and 5% patients had laparoscopic treatment. Conclusion: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.

Keywords: Ectopic pregnancy, Pelvic inflammatory disease, Risk factors, Salpingectomy, Tubal pregnancy