A case series on current management options of tubal ectopic pregnancy in a tertiary care unit

Abstract

Objective: To evaluate the feasibility of different management options of ectopic pregnancy in a local setup. Methods: This was a descriptive cross sectional study carried out at the Teaching Hospital, Peradeniya, Sri Lanka. All the patients who were diagnosed to have ectopic pregnancy during the study period of one year (2008) were included. The data collection was completed at the time of discharge of each patient. Information included, age, parity, period of gestation, clinical presentation, risk factors for ectopics, diagnosis (transvaginal scan and beta hCG) and type of treatment options (open surgery, laparoscopy, medical management and expectant management). A descriptive analysis of data was done in 21 patients with ectopic pregnancies. Results: Twenty one ectopic pregnancies were managed during the study period. A majority of cases (clinically stable patients with small gestational sac) 76% (16/21) were managed using treatment options, with continuous monitoring of each patient other than open surgery. Four clinically unstable patients and one patient with a large ectopic sac were subjected to laparotomy, while 8 clinically stable patients were offered laparoscopy, 7 systemic administrations of methotrexate and expectant management. Conclusions: It was found that most of the cases could be managed by treatment options other than open surgery. Early detection, clinical stability and size of the ectopic sac were