A clinical study on ectopic pregnancy in a tertiary care hospital over one year

Sharvari A. Khandkar; Rahi Modi; Mahima Jain

doi:10.18203/2320-1770.ijrcog20240138

Authors

Sharvari A. Khandkar Department of Obstetrics and Gynecology, B. J. Medical College, Ahmedabad, Gujarat, India
Rahi Modi Department of Obstetrics and Gynecology, B. J. Medical College, Ahmedabad, Gujarat, India
Mahima Jain Department of Obstetrics and Gynecology, B. J. Medical College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240138

Keywords:

Ectopic pregnancy, Hemoperitoneum, Laparoscopy, Laparotomy, Salpingectomy

Abstract

Background: Ectopic pregnancy is a life threatening emergency in obstetrics presenting in the 1^st trimester. The incidence is about 1% globally. We have aimed to study the incidence, presentation and management of ectopic pregnancy. Various risk factors were identified which may be helpful in reducing maternal mortality.

Methods: A one year retrospective study involving detailed medical records of patients who underwent obstetric hysterectomy between 1^st November 2022 and 31^st October 2023.

Results: The overall incidence of ectopic pregnancy was 0.8% in this study. The incidence was highest in 26-30 year age group (40%) followed by 21-25 year age group (36.4%). 95.2% cases presented with tubal ectopic while 2.4% each of cervical ectopic and caesarean scar ectopic pregnancies. LSCS was the most common risk factor associated with ectopic pregnancy, other risk factors included pelvic inflammatory disease in 33.3% cases, 29.5% patients with infertility treatment. 59% were ruptured ectopic pregnancies, 40% with unruptured ectopic pregnancy and 1% case of chronic ectopic. Multiple signs were seen in majority of patients including tachycardia, hypotension, abdominal tenderness, guarding and rigidity, vaginal forniceal fullness and tenderness. Management included laparotomy (58.8%), laparoscopy (31.7%), dilatation and evacuation (3.5%), medical management (3.5%) and hysterectomy (2.3%). No case of maternal mortality was noted.

Conclusions: Ectopic pregnancy is still a major challenge in obstetrical practice because of its bizarre clinical presentation. Maternal outcome depends upon timely diagnosis and urgent management of such patients.

Metrics

Metrics Loading ...

References

Moini A, Hosseini R, Jahangiri N, Shiva M, Akhoond MR. Risk factors for ectopic pregnancy: A case–control study. J Res Med Sci. 2014;19(9):844.

Mullany K, Minneci M, Monjazeb R, C. Coiado O. Overview of ectopic pregnancy diagnosis, management, and innovation. Women's Health. 2023;19:17455057231160349.

Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams Obstetrics. 26rd ed. Mc Graw Hill; 2022.

Barik S, Malakar A, Laha S. Trends in ectopic pregnancy: a prospective observational study from a tertiary care center in Eastern India. J South Asian Feder Obstet Gynaecol. 2020;12(3):173.

Soren M, Patnaik R, Sarangi BK. A clinical study on ectopic pregnancy. Int J Res Med Sci. 2017;5(11):4776-82.

Mehta A, Jamal S, Goel N, Ahuja M. A retrospective study of ectopic pregnancy at a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5241-6.

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).

Udigwe GO, Umeononihu OS, Mbachu II. Ectopic pregnancy: a 5 year review of cases at nnamdiazikiwe university teaching hospital (NAUTH) Nnewi. Niger Med J. 2010;51(4):160.

Wakankar R, Kedar K. ectopic pregnancy-a rising trend. Int J Sci Stud. 2015;3(5):18-22.

Jophy R, Thomas A, Mhaskar A. Ectopic pregnancy 5 years’ experience. J Obstet Gynecol India. 2002;52(4):55-8.

Pendse V. Ectopic pregnancy: a review of 110 cases. J Obstet Gynecol Ind. 1981;31:100-5.

Arora R, Rathore AM, Habeebullah S, Oumachigui A. Ectopic pregnancy-changing trends. J Ind Med Assoc. 1998;96(2):53-4.

Yadav DP, Bhati I, Bhati BS. Ectopic pregnancy: a comprehensive analysis of risk factors and management. Int J Reprod Contracept Obstet Gynecol. 2016;5(8):2723-7.