ANALYSIS OF TWO YEARS CASES OF ECTOPIC PREGNANCY

Authors

  • Ansa Islam Department of Gynecology & Obstetrics Ayub Teaching Hospital Abbottabad
  • Aneesa Fawad
  • Azmat Ali Shah
  • Humaira Jadoon
  • Irum Sarwar
  • Aziz-un-Nisa Abbasi

Abstract

Background: Ectopic pregnancy is the leading cause of pregnancy related deaths in the first trimester. The aim of this study was to evaluate the frequency of risk factors, clinical presentation, diagnostic methods and site of ectopic pregnancy Methods: This descriptive cross sectional study was conducted in Gynaecology and Obstetrical Unit-A of Ayub Teaching Hospital Abbottabad from 1st October 2013 to 31stOctober 2015. All women diagnosed with ectopic pregnancy were included in the study. A predesigned proforma was used to record the details about demographic features, risk factors, clinical features at presentation, diagnostic methods and site of ectopic pregnancy. Results: Out of total 6675 patients admitted during the study period, 45 cases of ectopic pregnancy were diagnosed with frequency of ectopic pregnancy to be 0.65%. Mean age of the patients was 28.98±5.525. Majority of patients were primigravida14(31.3%), 9 (20.0%) gravida 2, 5 (11.1%) gravida 3, 4 (8.8%) gravida 4, 7 (15.5%) gravida 5, 6 (13.3%) found grand multi out of total 45 ectopic pregnancies, 45% of the patients had no identifiable risk factors, however history of infertility 20 (22.22%), history of Pelvic inflammatory disease (PID) 10 (22.22%), previous ectopic 2 (4.44%) and previous abdominal pelvic surgery 3 (6.67%) were identified as common risk factors of 45 ectopic pregnancies. Out of total 45 sufferers 23 (51.11%) were clinically diagnosed, 20 (44.44%) through abdominal ultrasound and 2(4.44%) through transvaginal ultrasound. The most frequent clinical presentation was amenorrhea 30 (66.67%) followed by abdominal pain 28 (62.22%), irregular vaginal bleeding 18 (40.00%), asymptomatic patients with routine ultrasound 18 (40.0%) and 10 (22.22%) presented in shock. Twenty-eight (62.2%) of the ectopic pregnancies were found in right sided fallopian tube and 17(37.8%) were found in left sided fallopian tube. The commonest site of ectopic pregnancy was ampulla 29 (64.44%) followed by 11 (24.44%) Isthmus, 4 (8.89%) fimbrial end and 1 (2.22%) were rudimentary horn of uterus out of total 45 ectopic pregnancies. Evidence of 32 (71.1%) patients with ruptured ectopic was recorded. Thirteen (28.9%) were unruptured ectopic. Conclusion: Amenorrhea and abdominal pain are the most consistent features of ectopic pregnancy.Keywords: Ectopic pregnancy; Clinical presentation; Analysis of two years

Author Biography

Ansa Islam, Department of Gynecology & Obstetrics Ayub Teaching Hospital Abbottabad

Dr. Ansa Islam (Assistant Professor)Department of Gynecology & ObstetricsAyub Teaching HospitalAbbottabad

References

Mahboob U, Mazhar SB. Management of ectopic pregnancy: a two-year study. J Ayub Med Coll Abbottabad 2006;18(4):34–7.

Laxmi RC, Pradhan B, Duwa S. Annual Analysis of Ectopic Pregnancy in Tertiary Care Hospital.PMJN 2011;11(1):5–8.

Shetty S, Shetty A. A clinical study of ectopic pregnancies in a tertiary care hospital of mangalore, India. Innov J Med Health Sci 2014;4(1):305–9.

Mufti S, Rather S, Mufti S, Rangrez RA, Wasiqa K. Ectopic pregnancy: an analysis of 114 cases. JK-Pract 2012;17(4):20–3.

Kumar A, Chavali KH, Singh A, Kumar A, Dasari H. Death due to ruptured ectopic pregnancy natural death or negligence. J Indian Acad Forensic Med 2010;32(3):264–6.

Shivakumar HC, Umashankar KM, Ramaraju HE. Analysis of forty cases of ectopic pregnancies in tertiary care hospital in south India. Indian J Basic Appl Med Res 2013;3(1):235–41.

Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10 year population based study of 1800 cases. Hum Reprod 2002;17(12):3224–30.

Mohan S, Thomas M. Ectopic pregnancy: reappraisal of risk factors and management strategies. Int J Reprod Contracept Obstet Gynecol 2015;4(3):709–15.

Caraon SA. Buster JE. Ectopic pregnancy. N Engl J Med 1993;329(16):1174–81.

Jani RS, Munshi DS, Jani SK, Munshi SP. Study of 50 cases of modern management of ectopic pregnancy. Int J Reprod Contracept Obstet Gynecol 2014;3(2):374–9.

Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ectopic pregnancy. N Engl J Med 2000;343(18):1325–9.

Tulandi T, Saleh A. Surgical management of ectopic pregnancy. Clin Obstet Gynecol 1999;42(1):31–8.

Benson CB, Doubilet PM. Strategies for conservative treatment of cervical ectopic pregnancy. Ultrasound Obstet Gynecol 1996;8(6):371–2.

Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancy. J Fam Plann Reprod Health Care 2011;37(4):231–40.

Gupta R, Porwal S, Swarnkar M, Sharma N, Maheshwari P. Incidence, trends and risk factors for Ectopic Pregnancies in a tertiary care hospital of Rajasthan. J Pharm Biomed Sci. 2012;16(16):1–3.

Ayaz A, Emam S, Farooq MU. Clinical course of ectopic pregnancy: A single-center experience. J Hum Reprod Sci 2013;6(1):70–3.

Shaikh NB, Shaikh S, Shaikh F. A clinical study of ectopic pregnancy. J Ayub Med Coll Abbottabad 2014;26(2):178–81.

Parveen F, Tayyab S. Ruptured ectopic pregnancy. Clinical presentation and management. J Surg Pak 2007;12:47–51.

Tabassum R, Saeed MA, Ahmed M, Naureen S, Khan NH. Risk factors for tubal ectopic pregnancy .J Surg Pak 2005;10(4):22–5.

Musa J, Daru PH, Mutihir JT, Ujah IA. Ectopic pregnancy in Jos Northern Nigeria: prevalence and impact on subsequent fertility. Niger J Med 2009;18(1):35–8.

Majhi AK, Roy N, Karmakar KS, Banerjee PK. Ectopic pregnancy –an analysis of 180 cases. J Indian Med Assoc 2007;105(6):308–12.

Shabab U, Hashmi HA. Different pattern of presentation of ectopic pregnancy and its management. J Surg Pak 2013;18:(1):37–40.

Jurkovie D. Ectopic pregnancy. In Edmond DK, editor. Dewhursts text book of obstetrics and gynaecology 7th ed. USA: Blackwell; 2007. p.106–16.

Brodowska A, Szydlowska I, Starrezewski A, Strojny K, Puchalski A, Mieczkowska E, et al. Analysis of risk factors for ectopic pregnancy in own material in the year 1993-2002. Pol Merkur Lekarski 2005;18(103):74–7.

Kuroda K, Takeuchi H, Kitade M, Kikuchi I, Shimanuki H, Kumakiri J, et al. Assessment of tubal disorder as a risk factor for repeat ectopic pregnancy after laproscopic surgery for tubal pregnancy. J Obstet Gynaecol Res 2009;35(3):520–4.

Anorlu RI, Oluwole A, Abudu OO, Adebajo S. Risk factors for ectopic pregnancy in Lagos, Nigeria. Aeta Obstet Gynecol Scand 2005;84:184–8.

Karaer A, Avsar FA, Batioglu S. Risk Factors for ectopic pregnancy: a case control study. Aust N Z J Obstet Gynaecol 2006;46(6):521–7.

Khan B, Deeba F, Khan W. A 10 Year Review of 255 cases of Ectopic Pregnancy. J Androl Gynaecol 2013;1(2):1–4.

Akaba G, Agida T, Onafowokan O. Ectopic pregnancy in Nigeria’s federal capital territory: a six year review. Niger J Med J Natl Assoc Resid Dr Niger 2012;21(2):241–5.

Poonam, Upreti D, Banerjee B. Ectopic pregnancy; a two-year review from BPKIHS, Nepal. Kathmandu Univ Med J (KUMJ) 2005;3(4):365–9.

Prasanna B, Jhansi CB, Swathi K, Shaik MV. A study on risk factors and clinical presentation of ectopic pregnancy in women attending a tertiary care centre. IAIM 2016;3(1):90–6.

Gharoro EP, Ifbafe AA. Ectopic pregnancy revisited in Benin City, Nigeria: analysis of 152 cases. Acta Obstet Gynecol Scand 2002;81(12):1139–43.

Kaplan BC, Dart RG, Moskos M, Kuligowska E, Chun B, Adel Hamid M, et al. Ectopic pregnancy: Prospective study with improved diagnostic accuracy. Ann Emerg Med 1996;28(1):10–7.

Sotubo O, Aboyeji AP. Ectopic pregnancy in Ilorin, Nigeria: A five-year review. Niger Med Pract1994;27(3):25–7.

Murugesan A, Prabhu K, Muthulakshmi M. A retrospective study of ectopic pregnancies in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol 2016;5(8):2537–40

Published

2017-01-25

Most read articles by the same author(s)

1 2 > >>