DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20221275
Published: 2022-04-27

Management of ectopic pregnancies in a tertiary centre

Sunanda Bharatnur, Sai Snehitha Veluguleti

Abstract


Background: Ectopic pregnancies (EP) have become more common among young women in recent years. The incidence of EP has raised from 1.5-2% to 20.7 per 1000 pregnancies. As a result of early detection and treatment, the incidence of ruptured EP, maternal mortality, and morbidity has decreased. The purpose of this study is to examine all cases of EP in order to determine the incidence, as well as to investigate the risk factors, presentation, complications and management of EP.

Methods: This is a retrospective cohort study conducted at Kasturba medical college in Manipal, India. All EP data from 2014 to 2019 was obtained from medical records. EP incidence, risk factors, mortality, and morbidity were the primary outcome measures. IBM.SPSS software version 23.0 was used to collect statistical data.

Results: Over a five-year period, 436 EP were identified, with a 33/1000 pregnancy rate. The majority of women 243 (55.7%) were between the ages of 21 and 30. The most common risk factor was pelvic surgery (39.20%). 184 (42.2%) of the participants had classic EP symptoms, while 60 (13.76%) were asymptomatic. The 325 (74.5%) EP required surgical intervention. Methotrexate was used to treat 83 women (19.03%), 16 of whom were unsuccessful. The 86 (19.49%) women required blood transfusion. There were no reported deaths.

Conclusions: Assessing risk factors and diagnosing with TVS, serum hCG assays, and timely intervention can help in reducing the morbidity and mortality due to EP.


Keywords


EP, Risk factors for EP, Rising trends in ectopic, IVF and EP

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References


Shah P, Shah S, Kutty RV, Modi D. Changing epidemiology of maternal mortality in rural India: time to reset strategies for MDG-5. Trop Med Int Health. 2014;19(5):568-75.

Yadav K, Namdeo A, Bhargava M. A retrospective and prospective study of maternal mortality in a rural tertiary care hospital of central India. Indian J Community Health. 2013;25(1):16-1.

Mehta A. A retrospective study of ectopic pregnancy at a tertiary care centre. Int J Reproduct Contracept Obstetri Gynecol. 2017;6(12):5241-6.

Panchal DD, Vaishnav D, Solanki DK. Study of Management in Patient with Ectopic Pregnancy: Study of Management in Patient with Ectopic Pregnancy. National J Integrated Res Med. 2011;2(3):86-8.

Gaddagi RA, Chandrashekhar AP. A clinical study of ectopic pregnancy. J Clin Diag Res. 2012;6:867-9.

Poonam, Uprety D, Banerjee B. Ectopic pregnancy- two years review from BPKIHS, Nepal. Kathmandu University Med J. 2005;3(4):365-9.

Shetty S, Shetty A. A clinical study of ectopic pregnancies in a tertiary care hospital of Mangalore, India. Innov J Med Health Sci. 2014;4(1).

Singh S, Mahendra G, Vijayalakshmi S, Pukale RS. Clinical study of ectopic pregnancy in a rural setup: A two-year survey. Natl J Med Res. 2014;4(1):37-9.

Jabbar FA, Al-Wakeel M. A study of 45 cases of ectopic pregnancy. Int J Gynecol Obstet Off Organ Int Fed Gynaecol Obstet. 1980;18(3):214-7.

Jani R, Munshi D, Jani S, Munshi S. Study of 50 cases of modern management of ectopic pregnancy. Int J Reprod Contracept Obstet Gynecol. 2014;3(2):374-9.

Khaleeque F, Siddiqui RI, Jafarey SN. Ectopic pregnancies: A three-year study. J-Pak Med Assoc. 2001;51(7):240-2.

National Family Health Survey-4. 2016. Available at: http://rchiips.org/nfhs/factsheet_nfhs-4.shtml. Accessed on 2016 April 19.

Sudha VS, Thangaraj DR. A retrospective study on ectopic pregnancy: a two-year study. Int J Reprod Contracept Obstet Gynecol. 2016;5(12):4365-8.

Strandell A, Thorburn J, Hamberger L. Risk factors for ectopic pregnancy in assisted reproduction. Fertil Steril. 1999;71:282-6.

Tay JI, Moore J, Walker JJ. Ectopic pregnancy. West J Med. 2000;173(2):131-4.

Shagufta SM, Samina M, REyaz AR, Wasiqa K. Ectopic pregnancy; an analysis of 114 cases. JK- practitioner. 2012;17(4):20-3.

Shabab U, Hasmi HA. Different pattern of presentation of ectopic pregnancy and its management. J Surg Pak Int. 2013;18:1.

Tahmina S, Daniel M, Solomon P. Clinical Analysis of Ectopic Pregnancies in a Tertiary Care Centre in Southern India: A Six-Year Retrospective Study. J Clin Diagn Res. 2016;10(10):QC13-6.

Murray H, Baakdah H, Bardell T, Tuland T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005;173(8):905-12.

Cornelius AC, Onyegbule A, Onyema null, Uchenna ET, Duke OA. A five-year review of ectopic pregnancy at Federal Medical Centre, Owerri, South East, Nigeria. Niger J Med J Natl Assoc Resid Dr Niger. 2014;23(3):207-12.

Taheri M, Bharathan R, Subramaniam A, Kelly T. A United Kingdom national survey of trends in ectopic pregnancy management. J Obstet Gynaecol. 2014;34(6):508-11.

Van den Berg MMJ, Goddijn M, Ankum WM, Van Woerden EE, Van der Veen F, Van Wely M et al. Early pregnancy care over time: should we promote an early pregnancy assessment unit? Reprod Biomed Online. 2015;31(2):192-8.

Jurkovie D, Ectopic pregnancy. In Edmonds DK, Editor, Dew Hurst textbook of obstetrics and Gynecology 7th ed, USA: Blackwell Publishers. 2007.

Baria D, Thaker R, Patel M, Shah S, Shah P, Jani S. Analysis of ectopic pregnancy at a tertiary care hospital: one year study. Int J Reprod Contracept Obstet Gynecol. 2013;2(4):621.

Okmen F, Zeybek B, Akdemir A, Ergenoglu AM, Yeniel O, Ulukus M. Is there a relationship between age and side dominance of tubal ectopic pregnancies? A preliminary report. Ginekol Pol. 2014;85(9):677-81.

Berek JS, Adashi EY, Hillard PA, Jones HW. Novak's gynaecology. Baltimore, Williams and Wilkins. 1996.

Barnhart K, Hummel AC, Sammel MD. Use of 2 dose regimen of MTX to treat ectopic pregnancy. Fertil Steril. 2007;87:250-6.

French S, Henry T, Williams E. Evaluation of Waiting Times and Sonographic Findings in Patients with First Trimester Vaginal Bleeding at the University Hospital of the West Indies. Can Emergency Department Ultrasound Make a Difference? West Indian Med J. 2014; 63(3):247-51.

Horne AW, Shaw JL, Murdoch A, McDonald SE, Williams AR, Jabbour HN et al. Placental growth factor: a promising diagnostic biomarker for tubal ectopic pregnancy. J Clin Endocrinol Metab. 2011;96(1):E104-8.

Cabar FR, Pereira PP, Schultz R, Francisco RP, Zugaib M. Association between ultrasound findings and serum levels of vascular endothelial growth factor in ampullary pregnancy. Fertil Steril. 2015;103(3):734-7.