DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173664

Risk factors and management of ectopic pregnancy

Shradha S. Maka, Sangamesh B. Tondare, Mahesh B. Tondare

Abstract


Background: One of the critical and commonest acute abdominal emergencies which a gynaecologist has to manage in day to day practise is ectopic pregnancy. The present study is compilation to know the risk factors and different modalities of medical and surgical management of patients with ectopic pregnancy.

Methods: All patients diagnosed of Ectopic pregnancy at Basaveshwar teaching and general hospital and Sangameshwar teaching and general hospital attached to Mahadevappa Rampure Medical College were part of the study, over a period of two years (August 2014 to July 2016). It was a prospective study with pivot tables, graphs and chi square test.

Results: In a span of 2 years 50 cases were studied. Maximum age incidence was 21-25 years. Greater incidence was seen in primigravida accounting for 28%. Most patients presented with pain in abdomen (50 cases). Risk factors included previous abortion, contraception history, sterilization history and pelvic surgery. 47 cases underwent laparotomy and 3 cases were managed medically. 66% had tubal rupture and the most common site was ampulla. Post-operative period was uneventful in majority of cases.

Conclusions: With the increasing incidence of ectopic pregnancy, screening of high risk cases, early diagnosis and early intervention are required to prevent the maternal deaths and conservation of reproductive health.


Keywords


Ectopic pregnancy, Maternal deaths, Salphingectomy

Full Text:

PDF

References


Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL et al. Williams obstetrics. 24th ed. Mc Graw Hill Education. Chapter 19. 2014:377.

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. JPBMS. 2012;16(07).

Mufti S, Rather S, Mufti S, Rangrez RA, Wasiqa K. Ectopic pregnancy: an analysis of 114 cases. JK-Pract. 2012;17(4):20-3.

ICMR task force project 1990. Multicentric case control study of ectopic pregnancy. J Obstet Gynecol India. 1990;40:425-430.

Centers for Disease Control and Prevention (CDC. Ectopic pregnancy--United States, 1990-1992. MMWR. 1995;44(3):46.

Gaddagi RA, Chandrashekhar AP. A clinical study of ectopic pregnancy. J Clin Diag Res. 2012;6(5):867-9.

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):305-9.

Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005;173:905-912.

Ankum WM, Mol BW, Van der Veen F, Bossuyt PM. Risk factors for ectopic pregnancy: a meta analysis. Fertil Steril. 1996;65:1093-9.

Buckley RG, King KJ, Disney JD, Gorman JD, Klausen JH. History and physical examination to estimate risk of ectopic pregnancy: validation of a clinical prediction model. Ann Emerg Med. 1999;34(5):589-94.

Dart RG, Kaplan B,Varaklis K. Predictive value of history and physical examination in patients with suspected ectopic pregnancy. Ann Emerg Med. 1999;33:283-90.

Cheng MC, Wong YM, Rochat RW, Ratnam SS. Sterilisation failures in Singapore an examination of ligation techniques and failure rates. Stud Fam Plann. 1977;8:109-115.

Ory HW. Ectopic pregnancy and intrauterine contraceptive devices: new perspectives. The Women's Health Study. Obstet Gynecol. 1981;57(2):137-44.

Coste J, Job-Spira N, Fernandez H, Papiernik E, Spira A. Risk factors for ectopic pregnancy: a case-control study in France, with special focus on infectious factors. Am J Epidemiol. 1991;133(9):839-49.

Kendrick JS, Atrash HK, Strauss LT, Gargiullo PM, Ahn YW. Vaginal douching and the risk of ectopic pregnancy among black women. Am J Obstet Gynecol. 1997;176(5):991-7.

Govindarajan MJ, Rajan R. Heterotopic pregnancy in natural conception. J Hum Reprod Sci. 2008;1(1):37-8.

Ectopic Pregnancy. Text book of Williams Obstetrics. Multifetal Ectopic Pregnancy. 21st ed. Chapter 34. 2003:888-9.

Stabile I, Grudzinkas JG. Ectopic pregnancy whats new? Progress Obstet Gynecol.1994:281-310

Parry JS. Extrauterine pregnancy: Its causes, species, pathologic anatomy, clinical history, diagnosis, prognosis, and treatment. Philadelphia, Lea and Febiger, zit. Leach RE, Ory SJ (1989) Modern management of ectopic pregnancy. J Reprod Med. 1876;34:324-38.

YlÖstalo P, Cacciatore B, SjÖberg J, KÄÄriÄinen M, Tenhunen A, Stenman UH. Expectant management of ectopic pregnancy. Obstet Gynecol. 1992;80:345-8.