Ectopic Pregnancy- Study of Incidence, Risk Factors, Clinical Presentation, and Associated Morbidity in Tertiary Centre

BACKGROUND Ectopic pregnancy is one of the commonest acute abdominal emergencies a gynaecologist has to meet in the day-to-day practice. It is also a matter of great concern that a woman might have to face any time during her child bearing period. It not only threatens the life if not treated effectively in a timely manner, but also tells upon her fertility. Many pathological conditions present a percentage of variables but only few have greater disparity of symptoms, signs, opinions, and reports as ectopic, which has made ectopic pregnancy both an interesting and challenging problem, at times difficult to diagnose and manage. The objective of this study is to determine incidence, risk factors, clinical presentation and associated morbidity of ectopic pregnancy. METHODS The cross-sectional study was carried out in the Department of Gynaecology and Obstetrics of Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar. The study period was two years from March 2017 to February 2019. A total of 52 cases of ectopic pregnancies were studied for risk factors, clinical presentation and associated morbidity during the period of study. RESULTS The incidence of ectopic pregnancies is 1:114. The maximum number of ectopic gestations in the present series occurred between the age group 26 to 30 years and more in nulliparous and in the first and second gravidas. Majority of cases belonged to the low socioeconomic status. In the study, no risk factors were identified in 30.7% of the cases and various other risk factors were studied in remaining cases. The typical triad of amenorrhea, pain abdomen and bleeding were observed in 74.5% cases. Most of the patients were referred from outside with diagnosis of ruptured ectopic pregnancy, so treatment modality was surgical- laparoscopic unilateral salpingectomy in 71.1% cases. No morbidity or mortality were seen in the present study. CONCLUSIONS High index of suspicion is required in women in reproductive age group with lower abdomen pain irrespective of presence or absence of amenorrhea, whether or not she has undergone sterilisation to offer a conservative line of management in case of early diagnosis of ectopic pregnancy.