Ectopic pregnancy an obstetric emergency: retrospective study from medical college Ambala, Haryana, India

Shweta Tomar Yadav, Simmanjit Kaur, Sachin Singh Yadav


Background: Ectopic pregnancy remains the leading cause of maternal death in early pregnancy, the overall incidence of ectopic pregnancy is increasing but with improved diagnostic techniques and conservative management, case fatality rate has reduced. This study was undertaken to evaluate the incidence, clinical profile, associated risk factors, management and outcome of cases diagnosed as ectopic pregnancy.

Methods: This retrospective study was conducted at MMIMSR Mullana, Ambala from 1st January 2014 to 31 December 2015. All women admitted with ectopic pregnancy in the gynae department were taken in the study.

Results: The incidence of ectopic pregnancy in our institute was 0.97 %, mainly affecting young multiparous women, out of 36 cases 15 (41.7%) patients had risk factors previous abortion was commonest (19.4%), followed by history of infertility, tubal ligation, ectopic pregnancy, Cu T insertion. Acute abdominal pain was the commonest (94.4%) symptom 2/3 patients had tachycardia and abdominal tenderness, 10 were in shock. mild to moderate anemia present, while 17 % severely anemic, urine pregnancy test was positive in all. 5 hemodynamically stable patients given single dose intramuscular methotrexate, surgical intervention in 31 cases by either laparoscopy or laparotomy, laparoscopy in 4 patients, 1 had to be converted to laparotomy. Fallopian tubes were commonest site; Ampulla was the commonest site in tubal rupture.

Conclusions: The ectopic pregnancy remains a public health issue. Timely diagnosis and transfer to higher center in hemodynamically stable state along with the use of conservative surgery or medical management can reduce morbidity and mortality.


Ectopic pregnancy, Infertility, Methotrexate. Laparoscopy, Laparotomy

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Farquhar CM: Ectopic pregnancy. Lancet. 2005;366(9485):583-91.

Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancy. J Fam Plann Reprod Health Care. 2011;37(4):231-40.

Department of Health. In: Drife J, Lewis G, editors. Why Mothers Die:A Confidential Enquiry in to the Maternal Deaths in the United Kingdom. Norwich, UK: HMSO; 2001:282.

Prasanna B, Jhansi CB, Swathi K, Shaik MV. A study on risk factors and clinical presentation of ectopic pregnancy in women attending a tertiary care centre. IAIM. 2016;3(1):90-6.

Thonneau P, Hijazi Y, Goyaux N, Calvez T, Keita N. Ectopic pregnancy in Conakry, Guinea. Bull World Health Organ. 2002;80:365-70.

Royal college of London. Obstctritians and Gynaecologisls. Guideline No. 21 on the Management of Tubal Pregnancies. London: RCOG; 1999.

Tuli AG, Goyal S, Livingston D, Kurian AS. Ectopic pregnancy: a five year retrospective study in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2015;4:1400-3.

Gaddagi RA, Chandrashekha AP. rA clinical study of ectopic pregnancy. Journal of Clinical and Diagnostic Research. 2012;6(5):867-9.

Wakankar R, Kedar K. Ectopic pregnancy-rising trend at Indira Gandhi Government Medical College, Nagpur. Int J Sci Stud. 2015;3(5):18-22.

Sujata P, Pati BK, Sahoo G. Ectopic pregnancy-a five year review. Indian Journal of Perinatology and Reproductive Biology. 2014;04(2):21-4.

Majhi AK, Roy N, Karmakar KS, Banerjee PK. Ectopic pregnancy-an analysis of 180 cases. J Indian Med Assoc. 2007;105:308-12.

Igwegbe AO, Eleje GU, Okpola BC. An appraisal of the management of ectopic pregnancy in a Nigerian Tertiary Hospital. Ann Med Health Science Res. 2013;3(2):166-70.

Panchal D, Vaishnav G, Solanki K. Study of management in patient with ectopic pregnancy. National Journal of Integrated Research in Medicine. 2011;2(3):91-4.

Dutta DC, Haemorrhage in early pregnancy. In: Koner H, editor. Textbook of Obstetrics. Revised reprint of 7th edition; 2013:177-190.

Gupta R, Porwal S, Swarnkar M, Sharma N, Maheshwari P. Incidence, trends and risk factors for ectopic pregnancies in a tertiary care hospital of Rajasthan. J Pharm Biomed Sci. 2012;16(7):1-3.

Fageeh WM. Diagnosis and management of ectopic pregnancy in king abdulaziz university hospital: a four year experience. JKAU. Med Sci. 2008;15(2):15-25.

Olofsson JI, Poromaa IS, Ottander U, Kjellberg L, Damber MG. Clinical and pregnancy outcome following ectopic pregnancy; a prospective study comparing expectancy, surgery and systemic methotrexate treatment. Acta Obstet Gynaecol Scand. 2001;80(8):744-9.