Publication:

A study of epidemiology of ectopic pregnancies in a tertiary care hospital of Mumbai, India

Background Ectopic pregnancy is the result of a flaw in human reproductive physiology that allows the concept us to implant and mature outside the endometrial cavity which ultimately ends in the death of the fetus. Without timely diagnosis and treatment, ectopic pregnancy can become a life-threatening situation. Aim of the present study was to determine the incidence, clinical presentation, risk factors and immediate morbidity and mortality associated with ectopic pregnancy.

Methods The study was conducted among 194 patients with ectopic pregnancy in a tertiary care hospital, over a period of two year. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultra-sonogram and morbidity associated with ectopic pregnancy were noted.

Results The incidence of ectopic pregnancy was 0.76%. Etiological factors observed were pelvic inflammatory disease (13.9%), dilatation and curettage (8.8%), infertility (7.7%), previous abortions (7.2%), intrauterine contraceptive device (3.6%), previous ectopic pregnancy (2.6%) and history of sterilization (1.5%). The typical triad of amenorrhoea, pain in abdomen, and bleeding was observed in 76.5%. Surgery by open method in the form of salpingectomy (91.2%), salpingo-oophorectomy (5.7%) and salpingo-oophectomy ovarian cystectomy (4.1%) were the mainstay of management. Morbidity included anemia (24.2%) and blood transfusion (87.6%). No maternal mortality noted.

Conclusions Early diagnosis, proper assessment of principal risk factors and timely intervention in the form of conventional or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.