A CLINICAL STUDY OF ECTOPIC PREGNANCIES IN A TERTIARY CARE HOSPITAL OF MANGALORE, INDIA

Abstract

Background: Ectopic pregnancy is a common life-threatening condition. Diagnosis is frequently missed and should be considered in any woman in the reproductive age group presenting with abdominal pain or vaginal bleeding. Aims: To determine the incidence, clinical presentation, risk factors, treatment and morbidity and mortality associated with ectopic pregnancy. Material and Methods: Retrospective analysis of case histories of patients admitted with ectopic pregnancy at Government Lady Goshen Hospital, Mangalore was done. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultra-sonogram and at surgery and morbidity associated with ectopic pregnancy were noted. Results: A total of 31 cases of ectopic pregnancy were operated giving the incidence of ectopic pregnancy of 5.6/1000 deliveries. The commonest risk factors present were history of abortion (29 %), history of tubal surgery (9.6%), infertility (3.2%) and pelvic inflammatory diseases (3.2%).The commonest symptoms were  abdominal pain (80.6%), amenorrhea (77.4%) and abnormal vaginal bleeding (61.3%); and commonest signs were abdominal tenderness (64.5%), cervical excitation (51.6%)  and adnexal tenderness (48.4%). Surgery by open method in the form of salpingectomy (90.3%), salpingo-oophorectomy (6.5%) and salpingostomy (3.2%) were the mainstay of management. Morbidity included anemia (41.9%), blood transfusion (54.8%) and wound infection (32.2%). No maternal mortality noted. Conclusion: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.