Changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232267Keywords:
Ectopic pregnancy, Fallopian tube, Laparotomy, Pelvic infectionAbstract
Background: An ectopic pregnancy occurs outside the uterus and is a relatively common condition among women of childbearing age. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death. The aim of the study was to evaluate the changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH.
Methods: This study was undertaken among the patients admitted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital during the period from October 2012 to March 2013. Clinical evaluation of cases of ectopic pregnancy in terms of sociodemographic factors, presentations, risk factors, examination findings, per operative findings and management offered to the patients. The period from Data was entered in MS Excel and Statistical analysis was done using SPSS-24.
Results: Most of the patients were 20-30 years age group and mean age was 28.08±4.24 years. The frequency of ectopic pregnancy was 7.60%. High incidence was found among 0-1 parity (48%) and from a lower socioeconomic status. Commonest presentation was lower abdominal pain (94%), amenorrhoea (100%), P/V bleeding (38%) and syncopal attack (48%). Most of the cases was without contraceptic coverage (60%). Previous history of abortion/MR (50%), history of pelvic infection (30%) and history of D&C (16%) constitute the main bulk of risk factors. Most of the patients managed by laparotomy followed by salpingectomy which is still the standard treatment in many cases.
Conclusions: Study has found that previous abortions are major etiological factor for ectopic pregnancy than previous pelvic infection. Most of the patients were managed by laparotomy. The general public should be made aware the sign and symptoms of ectopic pregnancy. Proper and modern diagnostic tools and training program for these should be made available in all tertiary level hospital.
References
Nicks BA, Fitch MT, Manthey DE. A case of intrauterine molar pregnancy with coexistent ectopic pregnancy. The Journal of Emergency Medicine. 2009;36(3):246-9.
Betran AP, wajdyla D. National estimates for maternal mortality: an analysis based on WHO systemic review of maternal mortality and morbidity. BMC Public Health. 2005;5(1):1-2.
Akter S, Sultana S. Management of Ectopic Pregnancy in a Tertiary Care Hospital by Surgery. Bangladesh Journal of Obstetrics & Gynaecology. 2013;28(1):21-5.
Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancy. Journal of Family Planning and Reproductive Health Care. 2011;37(4):231-40.
May WE. Coping with Ectopic Pregnancies. Studia Bioethica. 2010;3(3).
Alen H. Decerney MD. Current Obstetrics & Gynecology Diagnosis & treatment. 10th ed. Norwalk: 1994; 265-272.
Stulberg DB, Cain LR, Dahlquist I, Lauderdale DS. Ectopic pregnancy rates in the Medicaid population. Am J Obset Gynecol. 2013;208(4):274.e1-7.
Abdulaziz Al-Turki H. Trends in ectopic pregnancies in eastern saudi arabia. International Scholarly Research Notices. 2013;2013.
Creanga AA, Shapiro-Mendoza CK, Bish CL, Zane S, Berg CJ, Callaghan WM. Trends in ectopic pregnancy mortality in the United States: 1980–2007. Obstetrics & Gynecology. 2011;117(4):837-43.
Archibong EL, Sobande AA. Ectopic pregnancy. Abdha, Saudi Arabia, Saudi Med J. 2000;21(4):330-4.
Khan MAT, Shamima Siddiqua, MM Alam. Etopic pregnancy-A diagnostic dilemma. Bangldesh J Obstet Gynaecol. 2004;19(1):7-10.
Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, et al. Risk factor for ectopic pregnancy: A comprehensive analysis based on a large case control, population-based stud in France. Am J of Epidemiol. 2003;157(3):185-94.
Pradhan P, Thapamagar SB, Maskey S. A profile of ectopic pregnancy at nepal medical college teaching hospital. Nepal Med Coll J. 2006;8(4):238-42.
Storeide O, Veholmen M, Eide M, Birgsjo P, Sandevi R. The incidence of ectopic pregnancy in Horlaland Country, Norway 1976-1993. Acta Obstet Gynacol Scand. 2007;76:345-9.
Tay JJ, J Moore, JJ Walker. Clinical review of ectopic pregnancy. BMJ. 2003;320:916-9.
Gharoro EP, Igbafe AA. Ectopic pregnancy revisited in Benin City, Nigeria: analysis of 152 cases. Acta Obstet Gynecol Scand. 2002;81(12):1139-43.
Kalandidi A, Doulgerakis M, Tezonou A. Induced abortions, contraceptive practices and tabacoo smoking as risk factors of ectopic pregnancy in Alhens, Greece. Br J Obstet Gynacol. 1991;98(2):207-13.
Westrom L. Influence of STD on infertility and ectopic pregnancy. Acta Eur Fertil, 1985;16:21-4.
Robertson JN, Hogston P, Ward ME. Gonococcal and chlamydial antibodies in ectopic and intrauterine pregnancy. Br J Obstet Gynaecol. 1988;95(7):711-6.
Bouyer J, Joel Coste, Taranch Shojaci, Jean-luc Pouly, Fernandez, et al. Risk factors for ectopic pregnancy. A Comprehensive analysis based on a large case control population based study in Franch. Am J Epidemiol. 2003;157(3):185-94.
Lozeau AM, Potter B. Diagnosis and management of ectopic pregnancy. Am Fam Physi. 2005;72(9):1707-14.
Airede LR, Ekele BA. Ectopic pregnancy in Sokoto, Northern Nigeria. Malawi Med J. 2005;17(1):14-16.