A Study of 50 cases of ectopic pregnancy in a tertiary care hospital

Abstract

Background: Ectopic pregnancy is one of the clinical conditions which always challenged the clinical acumen of obstetricians and gynecologists for its bizarre clinical picture. It presents as an acute emergency and a life-threatening event. The department of O & G, medical college and S.S.G. hospital Vadodara is the largest referral centre in central Gujarat, receiving many emergency obstetrics cases not only from distant rural areas in Gujarat but also from borderline villages of M.P and Rajasthan. Therefore, it was pertinent to us to understand the emergency obstetrics condition like ectopic pregnancy.

Methods: A retrospective study of randomly selected 50 cases of ectopic pregnancy admitted during June 2005 to November 2006, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital named SSG Hospital at Vadodara. All the cases diagnosed as ectopic pregnancy after histopathological confirmation were included in the study. Data regarding demographic parameters, booking status, mode of presentation, parity, symptoms, different treatment options and histopathological findings were recorded. Complete intraoperative finding and type of surgery were noted.

Results: In present series the ectopic pregnancy rate is 7.9/1000 birth. Most common age group presenting with ectopic pregnancy was 20-30 years. Lower abdominal pain, amenorrhoea, bleeding p/v were most common presenting symptoms. Majority of patients had a PID and infertility as a risk factor. 90% of cases presented with ruptured ectopic pregnancy. Surgical management is done in most of the cases.

Conclusions: To diagnose ectopic pregnancy high index of suspicion is required. Past history of PID and infertility & its treatment increases the incidence of ectopic pregnancy. Early diagnosis is the key for early management. The triad of bleeding per vaginum, abdominal pain and amenorrhoea should never be ignored.