DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196015

Clinical study on presentation and management of ectopic pregnancies in a tertiary care centre

Anjum Ara, Indu Chawla, Rasika Agarwal, Bangali Manjhi

Abstract


Background: Ectopic pregnancy means pregnancy outside the normal uterine cavity. It is the leading cause of maternal morbidity and mortality in first trimester. Early diagnosis and timely intervention can significantly improve the outcomes.

Methods: Retrospective observational study done in the department of obstetrics and gynecology ABVIMS and Dr. RML hospital, New Delhi from January 2016 to March 2019. Case records of 76 patients of confirmed ectopic pregnancy were retrieved and studied from the medical record section. The main aims were to see the clinical presentation, mode of diagnosis, predisposing risk factors; treatments offered and associated morbidity and mortality.

Results: The incidence of ectopic pregnancy in present study was 1.7%, highest in 21 to 30 years age multiparous patients. 85.1% presented as acute emergencies, 75% patients had classic triad of amenorrhea, pain and bleeding. Pain was the commonest symptom in 96.1%. The commonest clinical sign was adnexal mass and tenderness. Ultrasound findings had adnexal mass in 98.7% and free fluid in 84.7% cases with empty uterus in 100%. 90.7 % case were tubal ectopic and 69.73 % were ruptured. Surgery was the main treatment modality in 96.0% cases. Salpingectomy was the commonest surgery in 80.25%. There was 0% mortality and 78.9% cases required blood transfusions, 44.7% patients had no known risk factors whereas some of the common identifiable risk factors were history of previous abortion, previous pelvic surgeries and pelvic inflammatory disease.

Conclusions: ABVIMS and Dr. RML hospital is a tertiary care center so majority of patients with ectopic pregnancies presented late, as such surgery was the main treatment modality but there was 0% mortality in our study. Conservative treatments such as laparoscopy and medical management can also be offered to hemodynamically stable patients.


Keywords


Ectopic pregnancy, Mortality, Risk factors, Morbidity

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