A study of the incidence, clinical presentation, risk factors and morbidity associated with ectopic pregnancy

Abstract

Background: Ectopic Pregnancy is originated from ‘Ektopos’, a Greek word. In ectopic pregnancy the
fertilized ovum implants outside the endometrial cavity of the uterus1
. The most common extra uterine
pregnancy is the tubal pregnancy in which a fertilized ovum implants in the fallopian tubes. Tubal
pregnancies account for 98% of all ectopic gestations. Other sites like ovary, cervix, horn of the uterus,
caesarean scar and abdominal cavity are rare2
.
Objectives: To determine the incidence, risk factors, clinical features, morbidity associated with ectopic
pregnancy.
Material & Methods:
Study Design: Descriptive Cross sectional study.
Study area: Department of Obstetrics and Gynaecology, Narayana Medical College, Nellore, Andhra
Pradesh.
Study Period: June 2017-May 2018.
Study population: Patients suspected of having an ectopic pregnancy. Sample size: Study consisted a total of 46 subjects. Study tools and Data collection procedure: Data collection tool was used to collect the different information. Face to face interviews were conducted using data collection tool by the investigator including detailed history taking and relevant physical examination. A detailed history was taken from the patient (if the patient was in shock the history was taken retrospectively). After taking history physical examination was done especially for vital signs, abdominal examination, per vaginal examination, cervical excitation test and culdocentesis when needed. The basic investigations including haemoglobin, renal function test, blood grouping and Rh typing, urine pregnancy test and ultrasound examination were done in all patients. Additional investigations like serum beta hCG, doppler study, CT,
MRI were ordered in case of doubtful diagnosis. Results: Most common risk factor was previous medical abortion (19.5%) followed by IUCD (8.6%), D&C (6.5%), tubectomy (6.5%), OCP’s (6.5%), recanalisation (4.3%), appendicectomy (2.2%), Diagnostic Hysterolaparoscopy (2.2%), infertility (2.2%), IUI conception (2.2%), laparoscopy (2.2%), and previous ectopic (2.2%). Conclusion: Timely diagnosis and management in early pregnancy units with point of care ultrasonography can reduce the morbidity and mortality due to ectopic pregnancy. In conclusion, identifying underlying risk factors, availability of point of care ultrasound and timely intervention will
help reduce the morbidity and mortality due to ectopic pregnancy.