DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160569

Ectopic pregnancy: a cause for maternal morbidity

Priyadarshini B., Padmasri R., Jnaneshwari T. L., Sowmya K. P., Urvashi Bhatara, Hema V.

Abstract


Background: Despite the scientific and technological advances maternal morbidity and mortality continue to occur across the globe with regional variation. Ectopic pregnancy is one such cause which contributes to devastating fate of pregnant ladies. Over a period of time there have been variations in the incidence, cause, clinical presentation and management of ectopic pregnancy. The objective is to observe variations with respect to incidence, cause, clinical presentation and management of ectopic pregnancy

Methods: The present study was a 1year prospective and 1 year retrospective study from Dec 2012 to Nov 2014 at a tertiary medical college in Karnataka.  All diagnosed cases of ectopic pregnancy were enrolled in the study. Statistical methods employed in the present study were contingency table, chi-square test and contingency coefficient analysis (cross tabs procedure).

Results: 38 cases were studied during two year period out of which 94.8% were tubal pregnancies, 2.6% each were cervical pregnancy and pregnancy in the rudimentary horn of the uterus. Maximum incidence of tubal gestation was noticed between the age group of 21-30 years (60.1%). 55.2% were nulliparous and 29% were multiparas. Commonest mode of termination was rupture in 57.9% of the cases; tubal abortion was seen with haemoperitoneum in 26.3% of the cases.

Conclusions: Ectopic pregnancy remains a significant gynaecologic emergency, delay in diagnosis and treatment can be catastrophic, but early diagnosis and timely treatment can virtually eliminate need for surgical intervention.

Keywords


Ectopic, Pregnancy, Tubal

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References


Mark A, John A. Ectopic pregnancy. Te Linde’s Operative Gynaecoloy. 10th Ed. Philadelphia: Lippincott Raven; 2008:501-27.

Carson Sandra A, John Buster E. Current concepts: ectopic pregnancy. N Engl J Med. 1993;329:1174-81.

Fernandez H, Rain horn JD, Papyri E. Spontaneous resolution of ectopic pregnancy. Obstet Gynecol. 1988;71:171.

Cahill DF. Bleeding and pain in early pregnancy. High Risk pregnancy management options, James. D.K, 3rd Ed. Saunders, Elsevier; 2006:85-104.

Department of health; why mothers die: confidential enquiry into maternal deaths in the United Kingdom. In Drife J, Lewis G (eds): Norwich,UK:HMSO. 2001;282.

Savitha Devi Y. Laparoscopic treatment of ectopic pregnancy. J Obst Gyn India. 2000;50:69.

Jophy R, Thomas A, Mhaskar A. J Obst and Gyn India. 2002;52:55-8.

Stabile I, Grudzinski JG. Ectopic pregnancy; what’s new? In Studd J editor. Progress in obstetrics and gynaecology, Vol 11. Edinburgh:Churchill Livinstone; 2000:11:281.

Eastman NJ, Hellman L. Williams Obst. 12th edition. New York: Appleton century crafts; 1961:130.

ICMR task force project. Multicentric case control study of ectopic pregnancy in India. J Obst Gyn India. 1990;40:425-30.

Marchbanks PA, Annegero JF, Coullan CB, Strathy JH, Kurland LT. Risk factors for ectopic pregnancy. A population based study. JAMA. 1988;259:1823-7.

Bouyer J, Coste J, Shojaei T, Pouly J, Fernandez H. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003;157(3):185-94.

Butts S, Sammel M, Hummel A, Chittams J, Barnhart K. Risk factors and clinical features of recurrent ectopic pregnancy: a case control study. Fertil Steril. 2003;80:1340.

Brunham RC, Binns B, McDowell J, Paraskevas M. Obstet Gynecol. 1986;67:722.

Gupta U, Sharma P. Ectopic pregnancy- a prospective analysis of 100 cases. J Obst Gyn India. 1992;42:597-600.

Bouyer J, Coste J, Fernandez H. Sites of ectopic pregnacy: a 10 year population based study of 1800 cases. Hum Reprod. 2002;17:3224-30.

Kirk E, Bourne T. The nonsurgical management of ectopic pregnancy. Curr Opin Obstet Gynecol. 2006:18(6):587-93.

Buster JE, Krotz S. Reproductive performance after ectopic pregnancy. Semin Reprod Med. 2007;25(2):131-3.