December 2017 · Volume 6 · Issue 12 Page 5241
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Mehta A et al. Int J Reprod Contracept Obstet Gynecol. 2017 Dec;6(12):5241-5246
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
A retrospective study of ectopic pregnancy at a tertiary care centre
Archana Mehta, Shehla Jamal*, Neerja Goel, Mayuri Ahuja
INTRODUCTION
Ectopic pregnancy is defined as any intra or extra-uterine
pregnancy in which the fertilized ovum implants at an
aberrant site which is inconducive to its growth and
development.
1
It is catastrophic and life threatening
condition and one of the commonest acute abdominal
emergency in day to day practice affecting approximately
2% of all pregnancies.
2
It is the most important cause of
maternal mortality and morbidity in the first trimester.
3
An ectopic pregnancy is assuming greater importance
because of its increasing incidence and its impact on
future fertility.
4,5
It is a challenge for the obstetricians due
to its bizarre clinical presentation. Diagnosis requires a
high index of suspicion as the classic triad of amenorrhea,
abdominal pain and vaginal bleeding is not seen in all
cases. Women may present with non-specific symptoms,
unaware of an ongoing pregnancy or may even present
with hemodynamic shock. The early diagnosis of this
condition over the past two decades has allowed a
definitive medical management of unruptured ectopic
pregnancy with successful outcomes.
6,7
The overall
incidence of ectopic pregnancy is increasing in the past
three decades but due to early diagnosis and management
ABSTRACT
Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early
pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic
pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence,
clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.
Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics
and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic
pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.
Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries
representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were
gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk
factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of
cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was
seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method
was the mainstay of treatment (86.25%).
Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases
present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form
of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.
Keywords: Ectopic pregnancy, Haemoperitoneum, Salpingectomy
Department of Obstetrics and Gynecology, School of Medical Sciences and Research, Greater Noida, Uttar Pradesh,
India
Received: 10 October 2017
Accepted: 04 November 2017
*Correspondence:
Dr. Shehla Jamal,
E-mail: essjayoms@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175117