COURSE AND OUTCOME OF ECTOPIC PREGNANCY IN A GOVERNMENT TEACHING HOSPITAL

Dr. Minakshi Singh, Dr. Richa Sinha*, Dr. Chitra Joshi

ABSTRACT

Introduction: Ectopic pregnancy is defined as the implantation of the fertilized ovum at a site other than normal uterine cavity. Incidence ranges from 1-2 % of live births. Clinical presentation is varied and depends on acute or chronic rupture or unruptured ectopic pregnancy. Hence coming to a diagnosis can be difficult at times even for an experienced gynecologist. Objective: The present study involves a retrospective analysis of all cases of ectopic pregnancy who were admitted in the Department of Obstetrics and Gynaecology, Government Doon Medical College, Dehradun during April 2016 to April 2018. This study is aimed to find the incidence of ectopic pregnancy in the study population and evaluate clinical presentation, risk factors, age group, parity and outcome of ectopic pregnancy. Methods: A total of 52 patients who were diagnosed as ectopic pregnancy were retrospectively analyzed between the study periods. A detailed analysis of age, parity, presenting symptoms, high risk factors, findings on surgery and morbidity associated with ectopic pregnancy was done. Results: 52 patients admitted with ectopic pregnancy during the study period. The incidence was 2.78 per 1000 live births. 4 patients were excluded from study due to incomplete data. Majority of patients belonged to age group 20-29 years (62.5%) and were multigravida (64.58%). Majority of patients (43.75%) did not have any risk factors. Pain in abdomen was present in 89.2% cases, amenorrhea in 75.7 % cases and bleeding per vaginum in 43.2 % cases. In majority of cases (56.75%) no specific site was discovered at laparotomy. 72.9% patients had rupture ectopic, 18.91% were unruptured and 8.10% had tubal abortion. Almost all patients had intra and post-operative blood transfusions. Unilateral salpingectomy was the most common procedure done at laparotomy. There was no maternal mortality in our study. Conclusion: Ectopic Pregnancy is the leading cause of maternal mortality in the first trimester. The early diagnosis of ectopic pregnancy is of utmost significance as early diagnosis can give the lady a chance for conservative management and have a beneficial effect on her reproductive career.

Keywords: Ectopic pregnancy, Salpingectomy, Laparotomy.