DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172298

A clinical study of ectopic pregnancy: a five-year institutional experience

Malavika J. C., Prema Prabhudev, Bandamma N. S.

Abstract


Background: Ectopic pregnancy contributes significantly to maternal morbidity and mortality. There is a steady increase in the incidence of ectopic pregnancy over the past few decades, owing to rise in sexually transmitted infections, subfertility and its treatment with ART techniques. Objective of present work was to study the rate of ectopic pregnancy, associated risk factors, clinical course and management at SSIMS and RC.

Methods: This is a retrospective study carried out at SSIMS and RC, Davangere from 01st January 2012 to 30th April 2017. A detailed analysis of case sheets done and all parameters analyzed. Institutional ectopic rate was calculated per 1000 deliveries.

Results: Out of 43 women with ectopic gestation, 40 (93.02%) were tubal ectopic and 3 (6.98%) were ovarian ectopic. Institutional rate of ectopic is 11.54 per 1000 deliveries. STI’s are the commonest risk factor followed by subfertility. Diagnostic aid commonly used was pelvic ultrasound. There were no maternal deaths due to ectopic pregnancy. One third of the women presented with shock. 52.5% tubal and 66.6% ovarian ectopics were ruptured. All women with tubal ectopic were managed by salpingectomy either by open or laparoscopic method and ovarian ectopics managed by ipsilateral oophorectomy. Two-thirds of the women received blood transfusion and 5-7 days were required for post-operative recovery.

Conclusions: Ectopic pregnancy is one of the commonest gynecological emergency and there is a yearly increase in the rate of ectopic. STI’s and subfertility are important risk factors. Prevention, early detection and treatment of STI’s may play an important role in reducing the rate of ectopic pregnancy.


Keywords


Ectopic pregnancy, Pelvic ultrasound, STI’s, Subfertility

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References


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

Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancy. J Fam Plann Reprod Health Care. 2011;37(4):231-40.

Jurkovic D, Wilkinson H: Diagnosis and management of ectopic pregnancy. BMJ. 2011;342:d3397.

Anrolu RI, Oluwole A, Abudu OO, Adebajo S: Risk factors for ectopic pregnancy in Lagos, Nigeria. Acta Obstet Gynecol Scand. 2005;84(2):184-8.

Indian Council of Medical Research Task Force Project: Multicentre case-control study of ectopic pregnancy in India. J Gynaecol Obstet India. 1990;40:425-30.

Eshan N, Mehmood A. Ectopic pregnancy: an analysis of 62 cases. J Pak Med Assoc. 1998;48(2):26-9.

de Rosany P, Irvine LM. Reporting rates of ectopic pregnancy: are we any closer to achieving concensus? J Obstet Gynaecol. 2012;32(1):64-7.

Bag TS, Saha DP, Dasgupta N, Sarkar M, Mandal SK, Mondal T et al. Time trends in ectopic pregnancy over a decade- a retrospective hospital based study. J Indian Med Assoc. 2012;109(10):727-9.

De Muylder X. Ectopic pregnancy in Zimbabwe. Int J Gynecol Obstet. 1991;35(1):55-60.

Wedderburn CJ, Warner P, Graham B, Duncan WC, Critchely HO, Horne AW. Economic evaluation of diagnosing and excluding ectopic pregnancy. Hum Reprod. 2009;25(2):328-33.

Ville Y, Leruez M, Glowaczower E, Robertson JN, Ward ME. The role of Chlamydia trachomatis and Neisseria gonorrhoeae in the aetiology of ectopic pregnancy in Gabon. Br J Obstet Gynaecol. 1991;98(12):1260-6.

Lindow SW, Moore PJ. Ectopic pregnancy: analysis of 100 cases. Int J Gynaecol Obstet. 1988;27(3):371-5.

Bugalho A, Strolego F, Pregazzi R, Osman N, Ching C. Extrauterine pregnancy In Mozambique. Int J Gynaecol Obstet. 1991;34(3):239-42.

Amoko DH, Buga GA. Clinical presentation of ectopic pregnancy in Transkei, South Africa. East Afr Med J. 1955;72(12):770-3.

Gharoro EP, Igbafe AA. Ectopic pregnancy revisited in Benin City,Nigeria: analysis of 152 cases. Acta Obstet Gynaecol Scand. 2002;81(12):1139-43.

Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L et al. 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.

Kouam L, Kamdom-Moyo J, Doh AS, Ngassa P. Treatment of ectopic pregnancies by laparotomy in under-equipped countries. A series of 144 cases at the younde university hospital center (Cameroon). J Gynecol Obstet Biol Reprod (Paris). 1996,25(8):804-8.