Publication:

Comparison of efficacy safety morbidity and complications of conservative and surgical management of ectopic pregnancies in government TD medical college, Alappuzha, Kerala, India

Background Ectopic pregnancy is pregnancy with implantation of fertilized ovum outside the uterine cavity most commonly in the fallopian tube. Objective of the study was to compare the efficacy, safety, morbidity and complications of conservative and surgical management of ectopic pregnancy.

Methods This is a descriptive study at Government Medical College Alappuzha, Kerala, India to analyze safety morbidity efficacy and complications of conservative medical and surgical management of cases of ectopic pregnancy admitted over a period of one year from May 2011 to April 2012. The study group comprised of 81patients with early pregnancy complaining of abdominal pain, vaginal bleeding, amenorrhoea and no intra uterine gestationsonologically. After confirming diagnosis management options included conservative, surgical or medical management with methotrexate as per selection criteria. Maternal morbidity in terms of hospital stay, blood transfusion, side effects of drugs were compared in both groups.

Results Accurate diagnoses of cases were done. Presenting complaints of the study subjects where vaginal bleeding, abdominal pain and amenorrhoea, which was in variably present in all subjects. Laparotomy done in 71.6% case, methotrexate given for 27.2% cases, laparoscopy for 1.2% all without significant morbidity. Two cases of failed medical management had laparotomy in view of tubal rupture.Blood transfusion given for18.4% case.

Conclusions Hospital stay was more in medically managed group. Sticking on to proper selection criteria both methods are safe and effective without any complications or failure.