DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20162675

A case-control study to evaluate risk factors for ectopic pregnancy

Sangita Khedar, Premlata Mital, Lata Rajoria, Divya Gupta, Usha Shekhawat, Sunita Singhal

Abstract


Background: Morbidity and mortality associated with ectopic pregnancy are directly related to the length of time required for diagnosis. Knowledge of risk factors for ectopic pregnancy will help an obstetrician to suspect and diagnose the condition early. Therefore, the present study was designed to identify potential risk factors and to evaluate the contribution of the risk factors in ectopic pregnancy.

Methods: Study population consists of 65 women with ectopic pregnancy and for each ectopic case one woman with first trimester intrauterine pregnancy was recruited as control. Data were retrieved from all through a structured proforma. Data were analyzed statistically.

Results: Various significant risk factors for ectopic pregnancy found were pelvic inflammatory disease, tubal ligation, age above 30 yrs, previous use of IUCD, low socio-economic status, tubal infertility and genital tuberculosis while no significant association was seen with smoking, age below 30 years, history of prior induced abortion, oral contraceptive pills and clomiphene citrate.

Conclusions: Increase awareness and knowledge of risk factors will help obstetricians to suspect and diagnose ectopic pregnancy early and accurately and enable them to plan medical treatment. Surgical treatment will be reserved for ruptured ectopic pregnancy and haemodynamically unstable patients.

Keywords


Ectopic pregnancy, Risk factors, Pelvic inflammatory disease, Tubal ligation

Full Text:

PDF

References


Farquhar CM. Ectopic pregnancy. Lancet. 2005;366(9485):583-91.

Zane SB, Kieke BJ, Kendrick JS, Bruce C. Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. Matern Child Health J. 2002;6(4):227-36.

Chow WH, Daling JR, Cates WJ, Greenberg RS. Epidemiology of ectopic pregnancy. Epidemiol Rev. 1987;9:70-94.

Walker JJ. Ectopic pregnancy. Clin Obstet Gynecol. 2007;50(1):89-99.

Nama V, Manyonda I. Tubal ectopic pregnancy: diagnosis and management. Arch Gynecol Obstet. 2009;279:443.

ICMR Task Force Project. J Obst Gynec India. 1990;40(3):425.

Pradhan P, Thapamagar SG, Maskey S. A profile of ectopic pregnancy at nepal medical college teaching hospital. Nepal Med Coll J. 2006;8(4):238-42.

Parashi S, Moukhah S, Ashrafi M. Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women Shayesteh. Int J Fertil Steril. 2014;8(2):147-54.

Moini A, Hosseini R, Jahangiri N, Shiva M, Akhoond MR. Risk factors for ectopic pregnancy: a case-control study. J Res Med Sci. 2014;19(9):844-9.

Shraddha Shetty K. Clinical Study of Ectopic Pregnancies in a Tertiary care hospital of Mangalore Innovative Journal of Medical and Health Science. 2014;4(1):305-9.

Majhi AK, Roy N, Karmakar KS, Banerjee PK. Ectopic pregnancy - an analysis of 180 cases. J Indian Med Assoc. 2007;105(6):308, 310, 312.

Omokanye LO, Balogun OR, Salaudeen AG, Olatinwo AW, Saidu R. Ectopic pregnancy in Ilorin, Nigeria: A four year review. Niger Postgrad Med J. 2013;20:341-5.

Shetty VH, Gowda S, Muralidhar L. Role of ultrasonography in diagnosis of ectopic pregnancy with clinical analysis and management in tertiary centre hospital. J Obstet Gynaecol India. 2014;64(5):354-7

Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, Job-Spira N. 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.

Yuk JS, Kim YJ, Hur JY, Shin JH. Association between socio-economic status and ectopic pregnancy rate in the Republic of Korea. Int J Gynaecol Obstet. 2013;122(2):104-7.

Waylen AL, Metwally M, Jones GL, Wilkinson AJ, Ledger WL. Effects of cigarette smoking upon clinical outcomes of assisted reproduction: a meta-analysis. Hum Reprod Update. 2009;15(1):31-44.

Kim HJ, Cheun SH, Park HE, Yoon BM, Won PK. A clinical study of ectopic pregnancy. Korean J Obstet Gynecol. 2003;46(10):2022-7.

Cornelius AC, Onyegbule A, Onyema U, Chenna ET, Duke OA. A five year review of ectopic pregnancy at Federal Medial Centre, Owervi, South East, Nigeria. Niger J Med. 2014;23(3):207-12.

Cheng Li, Zhao WH, Zhu Q, Cao SJ, Ping H, Xi X. Risk factors for ectopic pregnancy: a multi-center case-control study. BMC Pregnancy Childbirth. 2015;15:187.

Barnhart KT, Sammel MD, Gracia CR, Chittams J, Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril. 2006;86:36-43.

Brenner PF, Roy S, Daniel R, Mishell. A study of 300 consecutive surgically treated cases. JAMA. 1980;243(7):673-6.

Lee KR, Lee JS, Kim HJ, Kim JH, Lee MS, Song IC. A clinical study of ectopic pregnancy. Korean J Obstet Gynecol, 2001.

Gupta U, Sharma P. Ectopic pregnancy – A prospective analysis of 100 cases. Obstet Gynec India. 1992;42:597-600.

Karaer A, Avsar FA, Batioglu S. Risk factors for ectopic pregnancy: a case-control study. Aust N Z J Obstet Gynaecol. 2006;46(6):521-7.

Sharma JB, Naha M, Kumar S, Roy KK, Singh N, Arora R. Gestational Tuberculosis: an important cause of ectopic pregnancy in India. Indian J Tuberc. 2014;61(4):312-7.

Zhang J, Li C, Zhao WH, Xi X, Cao SJ, Ping H. Association between levonorgestrel emergency contraception and the risk of ectopic pregnancy: a multicenter case-control study. Sci Rep. 2015;5:8487.