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A retrospective study on ectopic pregnancy: a two year study

V. S. Sudha, Delphine Rose Thangaraj.

Abstract
Background: Diagnosis of ectopic pregnancy was frequently missed and rising trend in incidence of ectopic pregnancies necessitates awareness about risk factors, resultant morbidity and mortality. Aim of the study was to determine the incidence, clinical presentation, risk factors, treatment and morbidity and mortality associated with ectopic pregnancy.
Methods: Retrospective analysis of ectopic pregnancy was done in Government Raja Mirasudhar Hospital from January 2014 to December 2015. The following parameters: age, parity, gestational age, risk factors, clinical presentation, site of ectopic, diagnostic methods, mode of treatment and morbidity were noted.
Results: Out of 27881 deliveries, 228 were ectopic pregnancies (0.81 %).
Women with age 20-25yrs had highest incidence (42.98%) and with least below 20yrs (9.64%). Ectopic pregnancies were common in multiparous women than primigravida (18.42%). Common symptoms: abdominal pain (82.4%), amennorhea (78.5%), bleeding per vaginum (63.3%), asymptomatic (12%) patients. Urine pregnancy test positive in 90.4%. Etiology was pelvic infection (15.78%), infertility (7.01%), previous ectopic (8.33%), contraception (6.14), surgeries including LSCS and tubal surgeries (6.57%). Right sided ectopic was more common. Site of ectopic: Common in fallopian tube- ampullary region (63.15%), cornua (13.15%), isthmus (11.40%), fimbria (7.01%), followed by ovarian ectopic (3.94%) then cervical, caesarean scar, rudimentary horn pregnancy with 0.43% each. About 66.66% of ectopic was ruptured, 3/4th of these patients presented with shock at the time of presentation. Tubal abortions were seen in 20.17% of patients. Most of cases being ruptured ectopic pregnancies, salpingectomy in 90.52% and salpingoopherectomy in 3.5%. Morbidity was blood transfusion (76.31%), wound complications 4.38 and no mortality.
Conclusions: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.

Key words: Amenorrhea, Ectopic pregnancy, Risk factors, Salpingectomy


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