DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174040

A study of epidemiology of ectopic pregnancies in a tertiary care hospital of Mumbai, India

Deepali Kharat, Prajakta Goswami Giri, Michelle Fonseca

Abstract


Background: Ectopic pregnancy is the result of a flaw in human reproductive physiology that allows the concept us to implant and mature outside the endometrial cavity which ultimately ends in the death of the fetus. Without timely diagnosis and treatment, ectopic pregnancy can become a life-threatening situation. Aim of the present study was to determine the incidence, clinical presentation, risk factors and immediate morbidity and mortality associated with ectopic pregnancy.

Methods: The study was conducted among 194 patients with ectopic pregnancy in a tertiary care hospital, over a period of two year. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultra-sonogram and morbidity associated with ectopic pregnancy were noted.

Results: The incidence of ectopic pregnancy was 0.76%. Etiological factors observed were pelvic inflammatory disease (13.9%), dilatation and curettage (8.8%), infertility (7.7%), previous abortions (7.2%), intrauterine contraceptive device (3.6%), previous ectopic pregnancy (2.6%) and history of sterilization (1.5%). The typical triad of amenorrhoea, pain in abdomen, and bleeding was observed in 76.5%. Surgery by open method in the form of salpingectomy (91.2%), salpingo-oophorectomy (5.7%) and salpingo-oophectomy ovarian cystectomy (4.1%) were the mainstay of management. Morbidity included anemia (24.2%) and blood transfusion (87.6%). No maternal mortality noted.

Conclusions: Early diagnosis, proper assessment of principal risk factors and timely intervention in the form of conventional or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.


Keywords


Ectopic pregnancy, Etiological factors, Salpingectomy, Salpingo-oophorectomy and ovarian cystectomy, Ultra-sonogram

Full Text:

PDF

References


Panti A, Ikechukwu NE, lukman OO, Yakubu A, Egondu SC, Tanko BA. Ectopic pregnancy at Usmanu Danfodiyo University Teaching Hospital Sokoto: a ten year review. Ann Niger Med. 2012;6(2):87-91.

Howkins and Bourne Shaw's Text book of Gynecology, 12th Ed. Publishers B.I. Churchil Livingstone Pvt Ltd.

Migda M, Migda M, Maleńczyk M, Wender-Ożegowska E. Heterotopic pregnancy in the absence of risk factors--diagnostics difficulties. Ginekol Pol. 2011;82(11):866-8.

Tenore J. Ectopic pregnancy. Am Fam Physician 2000;61(4):1080-8.

Stovall TG, Ling FW, Buster JE. Outpatient chemotherapy of unruptured ectopic pregnancy. Fertil Steril. 1989;51:435-8.

Stovall TG, Ling FW, Gray LA, Carson SA, Buster JE. Methotrexate treatment of unruptured ectopic pregnancy: A report of 100 cases. Obstet Gynecol 1991;77:749-53.

Pisarska MD, Carson SA, Buster JE. Ectopic pregnancy. Lancet. 1998;351:1115-20.

Timmerman D. Predictive models for the early diagnosis of ectopic pregnancy. Verh K Acad Geneeskd Belg. 2004;66:155-171.

Barnhart KT. Clinical practice. Ectopic pregnancy. N Engl J Med. 2009;361:379-87.

Jophy R, Thomas A, Mhaskar A. Ectopic pregnancy-5 year experience. J Obstet Gynecol India. 2012;52(2):55-8.

Eastman NJ, Hellman LM. Williams Obstetrics. 12 ed. Appleton-Century-Crofts, New York, 1961:373-95,437-50.

ICMR task free project. Multicentric case control study of ectopic pregnancy in India. J Obstet Gynaecol India. 1990;40:425.

Marchbanks PA, Annegers JF, Coulam CB, Strathy JH, Kurland LT. Risk factors for ectopic pregnancy: a population-based study. JAMA. 1988;259(12):1823-7.

Devi S. J Obstet Gynecol India. 2000;50(2):69-74.

Arora R, Rathore AM, Habebullah S, Oumachigui A. Ectopic pregnancy--changing trends. J Indian Med Assoc. 1998 Feb;96(2):53-4, 57.

Brunham RC, Binns B, McDowell J, Paraskevas M. Chlamydia trachomatis infection in women with ectopic pregnancy. Obstet Gynecol. 1986;67(3):722-6.

Dabota BY. Management and outcome of ectopic pregnancy in developing countries. Niger J Med. 2009;18(1):35-38.

Vyas PS. Epidermiology, diagnosis and management of ectopic pregnancy. LTMG Hospital, Sion, Mumbai. 1993-1998.