A study on management, morbidity and mortality of ectopic pregnancy attending a tertiary care centre at Rajiv Gandhi Institute of Medical Sciences General Hospital, Kadapa, Andhra Pradesh, India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20163493Keywords:
Ectopic pregnancy, Maternal morbidity and mortality, SalpingectomyAbstract
Background: Ectopic pregnancy is one of the life threatening condition, and catastrophic. It is commonest acute abdominal emergency in practice. The aim of the study was to study the management modalities and their outcome, morbidity and mortality in women with ectopic pregnancy.
Methods: This prospective study conducted in the Department of Obstetrics and Gynaecology at RIMS General Hospital, Kadapa for a period of 2 years. 50 cases of ectopic pregnancy were diagnosed and recruited for the study. TVS / TAS was done to diagnose and also to ascertain the severity of the condition. Apart from routine surgical profile, β-hCG assay was also performed.
Results: Out of 50 patients, 45 (98%) patients were managed by laparotomy, 4 patients were by laparoscopically, one patient was successfully managed by medical therapy. The most common site for ectopic was found in ampulla in 32 (68%) patients, followed by isthmus 6 (12.24%), ovary 5 (10.2%), interstitial 1 (2.04%), cornua 2 (4.08%), fimbria 1 (2.04%) and infundibulam 2 (4.08%). In our study group about morbidity, 48 cases post operative period was uneventful, 2 (4%) cases were admitted in ICU.
Conclusions: Early diagnosis of ectopic pregnancy and prompt conservative surgical or medical management is needed to reduces maternal morbidity and mortality and also helps in preserving fertility.
References
Gary CF, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23rd edition, by The Mc Grew-Hill Companies; Chapter 10, Ectopic pregnancy. 2010:238-254.
Barnhart K, Mennuti M, Benjamin J. Prompt diagnosis of ectopic pregnancy in an emergency department setting. Obstet Gynecol. 1994;84:1010.
Barnhart K, Esposito M, Coutifaris C. An update on the medical treatment of ectopic pregnancy. Obstet Gynecol Clin North Am. 2000;27:653-67.
Kadar N. Early recourse to laparoscopy in the management of suspected ectopic pregnancy. Accuracy and morbidity. J Reprod Med. 1990;35:1153-6.
Samuelsson S, Sjovall A. Laparoscopy in suspected ectopic pregnancy. Acta Obstet Gynecol Scand. 1972;51:31-5.
Chotiner HC. Nonsurgical management of ectopic pregnancy associated with severe hyper stimulation syndrome. Obstet Gynecol. 1985;66:740-3.
Khaleeque F, Siddiqui RI, Jafarey SN. Ectopic pregnancies: A Three year study. J Pak Med Assoc. 2001;51:240-3.
Shrestha J, Saha R. Comparison of laparoscopy and laparotomy in the surgical management of ectopic pregnancy. J Coll Physicians Surg Pak. 2012;22:760-4.
Kopani F, Rrugia A, Manoku N. Ectopic pregnancy comparison of different treatments. Journal of Prenatal Medicine. 2010;4(2):30-4.
Etuknwa BT, Okpara AO, Imo PA, Ekandem GJ. Ectopic pregnancy: A Nigerian Urban Experience. Korean J Obstet Gynecol. 2012;55(5):309-14.
Poonam Y, Uprety D, Banerjee B. Ectopic Pregnancy - two years review from BPKIHS, Nepal. Kathmandu Uni Med J. 2005;3:365-9.
Shabab U, Hashmi HA. Different Pattern of Presentation of Ectopic Pregnancy and its Management. Journal of Surgery Pakistan (International). 2013;18(1).
Panchal D, Vaishnav G, Solanki K. Study of Management in Patient with Ectopic Pregnancy. NJIRM. 2011;2(3):91-4.
Shetty SK, Shetty AK. A clinical Study of Ectopic pregnancies in a Tertiary Care Hospital of Mangalore, India: Innovative Journal of Medical and Health Science. 2014;4(1):305-9.
Yakasai IA, Abdullahi J, Abubakar I. Management of ectopic pregnancy in Aminu Kano Teaching Hospital Kano Nigeria: A 3- year. Global Adv Res J Med Med Sci. 2012;1(7):181-5.
Gaddagi RA, Chandrashekhar AP. A Clinical Study of Ectopic Pregnancy. JCDR. 2012;6:867-9.