Risk factors associated with ectopic pregnancy in our sociodemographic setup

Abstract

Background: Ectopic pregnancy (EP) is assuming greater importance because of its increasing incidence and its impact on woman’s fertility.Aim: To assess the frequency and to determine an association between the studied risk factors and ectopic pregnancy.Methods: A retrospective study was conducted for the role of several risk factors in the occurrence of EP in department of obstetrics and Gynaecology, SMGS Hospital. A total of 110 cases and 110 controls were compared for socio demographic characteristics, cigarette smoking, obstetrical and gynaecological history, PID, past exposure to Chlamydia, surgical histories, the presence of assisted conception and contraceptive usage.Results: The main risk factors for ectopic pregnancy were history of tuberculosis (TB) (odds ratio (OR)=12.11), history of infertility (p=0.001), abortions (p=0.01) and a history of prior ectopic pregnancy (OR=8.549). Other risk factors found to be associated with an increased risk for ectopic pregnancy were Pelvic inflammatory disease (PID)/Chlamydia infection (OR=5.63), endometriosis (5.40), induced conception cycle (OR=3.063), intrauterine device usage (OR=3.55), prior caesarean section (OR=2.83) and appendectomy (OR=2.25). On the contrary, barrier methods (OR=0.28) and oral contraceptive use (OR=0.28) were protective from ectopic pregnancy.Conclusion: Pelvic infection particularly TB was found to be a major etiological factor for EP in our setup. Furthermore, other factors found to be associated with ectopic pregnancy, such as prior ectopic pregnancy and infertility history may be the result of a previous pelvic infection that caused tubal sequele. Thus, these factors are potential targets for intervention and modification. Further, patients with previous abortions, pelvic surgeries, induced conception cycle and intrauterine contraceptive device (IUCD) users should be counselled about the possible risk when they conceive.

Evaluation of Risk Factors Associated with Ectopic Pregnancy in Our Sociodemographic Setup: A Prospective Observational Study

“…7 21,22 We observed that patients with endometriosis were more prevalent in cases (11.7% vs. 1.7%; p-value=0.028), indicating that endometriosis has an association with ectopic pregnancy, which is in consonance with study of Jobspira N et al, Gandotra et al and Hunter RHF. 7,23,24 In the present study, we found that infertility was more common among patients with ectopic pregnancies (18.3% vs. 3.3%; p-value=0.008*), Tuomivaara and Ronnberg have assessed 929 infertile couples with regard to ectopic pregnancy in a follow-up investigation. Their research revealed rates of 46% for conception and 9% for ectopic pregnancies, respectively.…”

“…16 The risk of ectopic pregnancy was also found to increase among patients with lower socioeconomic status (56% vs 13.3%; p-value0.001), which is consistent with multitude of studies due to Gandotra et al, Yuk et al and Aboyeji et l, who reported that lower socio-economic status was more prevalent among patients with ectopic pregnancies. 7,17,18 In the present study, we found that patients with history of abortions were more common in cases compared to controls (23.3% vs. 8.3%;p-value=0.024*), which infers that history of abortions play a significant role in the development of ectopic pregnancies. Much similar observations have been reported by Gndotra et al, Tharaux-Beneux et al and Bouyer et a, who reported a significant association between history of abortions and ectopic pregnancies.…”

“…Much similar observations have been reported by Gndotra et al, Tharaux-Beneux et al and Bouyer et a, who reported a significant association between history of abortions and ectopic pregnancies. 7,8,19 Consitent to this; Gandotra et al in their study reported that the main risk factors for ectopic pregnancy were history of tuberculosis (TB) (odds ratio (OR)=12.11). 7 21,22 We observed that patients with endometriosis were more prevalent in cases (11.7% vs. 1.7%; p-value=0.028), indicating that endometriosis has an association with ectopic pregnancy, which is in consonance with study of Jobspira N et al, Gandotra et al and Hunter RHF.…”

“…7,8,19 Consitent to this; Gandotra et al in their study reported that the main risk factors for ectopic pregnancy were history of tuberculosis (TB) (odds ratio (OR)=12.11). 7 21,22 We observed that patients with endometriosis were more prevalent in cases (11.7% vs. 1.7%; p-value=0.028), indicating that endometriosis has an association with ectopic pregnancy, which is in consonance with study of Jobspira N et al, Gandotra et al and Hunter RHF. 7,23,24 In the present study, we found that infertility was more common among patients with ectopic pregnancies (18.3% vs. 3.3%; p-value=0.008*), Tuomivaara and Ronnberg have assessed 929 infertile couples with regard to ectopic pregnancy in a follow-up investigation.…”

Incidence and risk factors associated with ectopic pregnancy: a prospective study

“…Gandotra et al found that although contraceptive methods like barrier and oral contraceptives was found to lower the risk, contraceptive methods like POP (OR 7.19) and IUCD (OR 3.55) were found to increase the risk for ectopic pregnancy. 23 Emergency contraception use in current pregnancy accounted for 2% of ectopic pregnancy in present study. Jain et al found that hormonal emergency contraceptive pills failure rate is high when used in periovulatory period with increased chance of EP.…”