Publication:

A clinical study of ectopic pregnancy: a five-year institutional experience

Background Ectopic pregnancy contributes significantly to maternal morbidity and mortality. There is a steady increase in the incidence of ectopic pregnancy over the past few decades, owing to rise in sexually transmitted infections, subfertility and its treatment with ART techniques. Objective of present work was to study the rate of ectopic pregnancy, associated risk factors, clinical course and management at SSIMS and RC.

Methods This is a retrospective study carried out at SSIMS and RC, Davangere from 01st January 2012 to 30th April 2017. A detailed analysis of case sheets done and all parameters analyzed. Institutional ectopic rate was calculated per 1000 deliveries.

Results Out of 43 women with ectopic gestation, 40 (93.02%) were tubal ectopic and 3 (6.98%) were ovarian ectopic. Institutional rate of ectopic is 11.54 per 1000 deliveries. STI’s are the commonest risk factor followed by subfertility. Diagnostic aid commonly used was pelvic ultrasound. There were no maternal deaths due to ectopic pregnancy. One third of the women presented with shock. 52.5% tubal and 66.6% ovarian ectopics were ruptured. All women with tubal ectopic were managed by salpingectomy either by open or laparoscopic method and ovarian ectopics managed by ipsilateral oophorectomy. Two-thirds of the women received blood transfusion and 5-7 days were required for post-operative recovery.

Conclusions Ectopic pregnancy is one of the commonest gynecological emergency and there is a yearly increase in the rate of ectopic. STI’s and subfertility are important risk factors. Prevention, early detection and treatment of STI’s may play an important role in reducing the rate of ectopic pregnancy.