A STUDY OF INCIDENCE, CLINICAL PRESENTATION AND RISK FACTORS ASSOCIATED WITH ECTOPIC PREGNANCY

Abstract

K. Sarada Bai1, R. Sujatha2

In the past two decades the incidence of ectopic pregnancy has been increasing dramatically worldwide.

AIM: The aim of present study is to know the incidence, risk factors, clinical presentation of Ectopic pregnancy.

MATERIALS AND METHODS: Three year study of 192 cases of diagnosed ectopic pregnancy from 2011 December to November 2014 was conducted in the department of Obstetrics and gynaecology, King George hospital, Visakhapatnam. Factors like age, parity, risk factors like smoking, pelvic inflammatory diseases, h/o Tubectomy, treatment for infertility, previous abortion, IUCD (Intra Uterine Contraceptive Device)usage, H/o previous ectopic pregnancy, dilatation and curettage, surgeries, clinical presentations and treatment were included and analyzed. Exclusive criterion is intra uterine pregnancy.

RESULTS: Incidence of ectopic pregnancy in present study is 1 in 88 pregnancies. Out of 192 cases 34.37% belonged to 26-30 years, 31.28% in 21-25 years, 40% were multipara, 33.5% were associated with failed tubectomy. 21% had previous abortion, 10.9% were treated for infertility, 2.3% had previous ectopic pregnancy. Almost all the patients presented with abdominal pain, 39% presented in shock, and 78.1% had anaemia. Culdocentesis was positive in 46.9%. The most common site was ampullary part of tube. Least common site was interstitial part of tube. In 85.1% of cases had haemoperitoneum was more than 250 ml. In 62.5% of the cases were presented with right sided ectopic pregnancy. 96.8% required blood transfusion. Post-operative period was uneventful in all cases.

Conclusion: The incidence of ectopic pregnancy has been increasing especially after the year 2000. The risk increases with tubectomy, IUCD users, Infertility, Previous abortion and D&C, PID. On other hand oral contraceptive pills has got very good protection against ectopic pregnancy.

image