Clinical study of ectopic pregnancy in a tertiary care centre in Andhra Pradesh

Abstract

Background: If not detected early, ectopic pregnancy can result in a gynaecological emergency with significant abdominal bleeding, hypovolemic shock, and maternal death. The main objectives of this study are to find out the incidence of ectopic pregnancy, demographic profile of the women, risk factors and to study the clinical presentation, treatment modalities and outcome in our hospital. Methods: This prospective observational study was conducted in the department of obstetrics and Gynaecology, at a tertiary care centre, Andhra Pradesh from January 2021 to December 2022. A total of 62 cases of ectopic pregnancy were analysed for parameters like demographic characteristics, gravidity, risk factors, clinical presentation, treatment modalities and outcome. Results:The incidence of ectopic pregnancy in present study was 9.7 per thousand deliveries. Majority of cases belonged to age group of 21-25 years (67.7%) and were gravida 3 and above (49.1%). Commonest risk factors identified were tubal ligation (29%) and history of previous abortions (19.3%). The frequent presenting symptoms were abdominal pain (87%) and amenorrhea (38.7%). Most of the patients required surgical management (91.9%), medical management was done in 4 cases and expectant management was done in 1 case. Tubal ectopic pregnancy (87%) is more common. Anaemia was seen in 64.5% of cases that required multiple blood transfusions (72.5%) for resuscitation. There was no maternal mortality in the current study. Conclusions: Ectopic pregnancy is an emergency in which timely intervention will reduce the maternal morbidity and mortality. Clinical presentation varies from case to case and still there is a chance of missing the diagnosis in a small proportion of patients even with the availability of advanced imaging techniques. For early diagnosis a clinician should be aware about the various presentations and associated risk factors of ectopic pregnancy.