DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20174671

A clinical study on ectopic pregnancy

Mamata Soren, Ranjita Patnaik, Bismoy Kumar Sarangi

Abstract


Background: Ruptured ectopic pregnancy is a medical emergency; therefore, it is imperative to diagnose the unruptured ectopic pregnancy such that timely intervention will prevent morbidity and mortality Today with availability of monoclonal β-HCG, high resolution transvaginal scan and laparoscopy it is possible to make early diagnosis even before rupture.

Methods: Prospective study of two years duration with sample of 72 cases of suspected ectopic pregnancy observed and treated out of total 20193 pregnant women admitted were included in this study.

Results: The incidence was 0.36%, maximum between the age group of 26-30 years (33.3%). Risk factors were tubectomy (30.56%), D and C (6.94%), PID (5.6%), previous ectopic (1.39%), IUCD (2.78%). The typical triad of amenorrhoea, pain abdomen and bleeding was observed in 54.2% of cases. 19 patients were brought in shock (26.4%). Ultrasonography done in 56 cases.

Conclusions: There is an increase in the incidence of ectopic pregnancy but a decrease in maternal mortality during the past two decades. Although the early diagnostic tools were available, we had to manage most of our patients as surgical emergencies, as they were brought late in the trial, with established diagnosis of ruptured ectopic pregnancy. Physicians should be sensitive to the fact that in the reproductive age group any women presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be entertained irrespective of the presence or absence of amenorrhoea, whether or not she has undergone sterilization.

 


Keywords


Ruptured ectopic pregnancy, Tubectomy, Transvaginal scan

Full Text:

PDF

References


Odendaal HJ, Schaetzing AE, Kruger TK. Textbook of Clinical Gynecology. 2nd Ed. Juta Academic publisher. Cape Town, South Africa;2001.

Jophy R, Thomas A, Mhaskar A. Ectopic pregnancy 5 years’ experience. J Obstet Gynecol India. 2002;52(4):55-8.

ICMR -task free project. Multicentric case control study of ectopic pregnancy in India. J Obstet Gynaecol India 1990; 40: 425-30. 24.

Levin AA, Schoenbaum SC, Stubblefield PG, Zimicki S, Monson RR. Ectopic pregnancy and prior induced abortion. Am J Public health. 1982 Mar;72(3):253-6.

Marchbanks PA, Hillis SD, Owens LM, Amsterdam CF, Mac Kenzie WR. Recurrent chlamydial infections increases the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease. Am J Obstet Gynecol. 1997 Jan;176(1 Pt 1):103-7.

Savitha DY. Laparoscopic treatment of ectopic pregnancy. J Obst Gyn India. 2000;50:69.

Brunham RC, Peeling R, Maclean I, Kosseim ML, Paraskevas M. Chlamydia Trachomatis -associated ectopic pregnancy: serologic and histologiccorrelates. J Infect Dis. 1992;165(6):1076-81.

McCausland A. High rate of ectopic pregnancy following laparoscopic tubal coagulation failures: incidence and etiology. Am J Obstet Gynecol. 1980;136:97.

Marchbanks PA, Annegero JF, Coullan CB, Strathy JH, Kurland LT. Risk factors for ectopic pregnancy: a population based study. JAMA. 1988;259:1823-7.

Pendse V. Ectopic pregnancy: a review of 110 cases. J Obstet Gynecol Ind. 1981;31:100-5.

Arora R, Rathore AM, Habeebullah S, Oumachigui A. Ectopic pregnancy--changing trends. J Indian Med Assoc. 1998 Feb;96(2):53-4.

Khera KR. Ectopic pregnancy CA study of 55 cases. J Obstet Gynecol India. 1988;18:4-9.