A CLINICAL STUDY OF ECTOPIC PREGNANCY
AbstractBackground: The frequency of ectopic pregnancy is increasing throughout the globe and it is the most life threatening emergency in first trimester of pregnancy. Objective of this study was to determine the frequency, risk factors, clinical presentation and management of ectopic pregnancy. Methods: This prospective descriptive study was conducted in Gynaecology and Obstetrical Unit-II of Liaquat University of Medical and Health Sciences Hospital Hyderabad from 1st May 2009 to 30th April 2012. All women diagnosed with ectopic pregnancy were included in the study. A predesigned pro forma was used to record the details about demographic features, pre-existing risk factors, clinical features at presentation and management of ectopic pregnancy. Data was analysed using SPSS-11. Results: Total numbers of admission during study period were 9600 with 60 cases of ectopic pregnancy, thus representing the frequency of 0.6% (1 in 160). Majority of women 43 (72%) were of 20–30 year age, multigravida 31 (52%) were the most sufferers. Pelvic inflammatory disease 27 (45%), previous abortion 20 (33%), previous surgery 12 (20%) were seen as common risk factors; however no risk factor was identified in 21 (35%) women. Typical history of amenorrhea and abdominal pain was found in 46 (77%) women, 23 (38%) were in a state of shock. Laparotomy was performed in 53 (88%) women. Three (5%) women were treated successfully with methotrexate. Laparoscopic surgery was done in 2 patients and 2 patients were required both Laparoscopy proceeded by laparotomy. No maternal death related to ectopic pregnancy was reported in our study. Conclusion: The early diagnosis of an ectopic pregnancy is one of the greatest challenges for obstetricians. The importance of early diagnosis lies in the fact that the lady can be offered a conservative line of management which can definitely have beneficial on her reproductive carrier.Keywords: Ectopic pregnancy, Pelvic inflammatory disease, Abortion, laparotomy, methotrexate
Klentzeris LD, Shaw RW, Soulter WP, Stanton SL. Ectopic pregnancy. In editors. Gynaecology 3rd ed. London: Elsevein 2003;371–84.
Anorlu RI, Oluwole A, Abudu OO, Adebajo S. Risk factors for ectopic pregnancy in Logos Nigeria. Acta Obstet Gynecol Scand 2005;84:184–8.
From the Centers for Disease Control and Prevention. Ectopic pregnancy--United States, 1990-1992. JAMA 1995;273:533.
Rajkhowa M, Glass MR, Rutherford AJ, Balen AH, Sharma V, Cuckle HS. Trends in incidence of ectopic pregnancy in England and Wales from 1966-1996. Br J Obstet Gynecol 2000;107:369–74.
Boyd DW, Mclntyre JC, Kaunitz MA. Ectopic pregnancy. In: Gy I, Benrubi MD, editors. Hand book of obstetrics and gynaecologyic emergencies. 3rd ed. USA: Lippincott Williams & Wilkins; 2005.
Tenore JL. Ectopic pregnancy. Am Fam physician 2000;61:1080–8.
Jurkovie D. Ectopic pregnancy. In Edmond DK, editor. Dewhursts text book of obstetrics and gynaecology 7th ed. USA: Blackwell; 2007.p. 106–16.
Tang, Baartz D, Khoo SK. A medical management ofinterstitial pregnancy: a 5 years clinical study. Aust NZ J Obstet Gynaecol 2006;46:107–11.
Yang SB, Lee SJ, Joe HS, Goo DE, Chang YW, Kim DH. Selective uterine artery embolization for management of interstitial pregnancy. Korean J Radiol 2007;8(2):176–9.
Mehboob U, Mazhar BS. Management of ectopic pregnancy: A two year study. J Ayub Med Coll Abottabad 2006;18(4):34–7.
Archibong EL , Sobande AA. Ectopic pregnancy in . Abha Saudi Arabia. A continuing corundum. Saudi Med J 2000;21:330–4.
Aziz S, Al Wafi B, Al Swadi H. Frequency of ectopic pregnancy in a Medical centre, Kingdom of Saudi Arabia. J Pak Med Assoc 2011;61:221–4.
Majhi AK, Roy N, Karmakar KS, Banerjee PK. Ectopic pregnancy –an analysis of 180 cases. J Indian Med Assoc 2007; 105 (6):308.310,312.
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.
El-Tabbakh MN, El-Sayes MN. Tubal Ectopic Pregnancy: Laproscopic versus laprotomy. Available at: http://hcp.obgyn.net/Laproscopy/content article/1760982/1891240.
Gaddagi RA, Chandrashekhar AP. A Clinical Study of Ectopic Pregnancy. J Clin Diagn Res 2012;6:867–69.
Aboyeji AP, Fawole AA, Ijaiya MA. Trends in ectopic pregnancy in Ilorun, Nigeria. Nigerian J Surg Res 2002;4(1–2):6–11.
Veersema S, Damoiseaux A. Ruptured ectopic (corneal) pregnancy. J minim Invasive Gynecol 2009;16:666.
Malik AM, Aziz A. Tubal Ectopic pregnancy: Critical evaluation of presentation and management. Professional Med J 2001;8:208–13.
Imran A, Mustafa N, Akhtar N. Frequency of different presentation and surgical management of ectopic pregnancy at combined Miltary Hospital Lahore. Pak Armed Forces Med J 2009,3. Available at: http://www.pafmj.org/showdetails.php?id=252&t=o
Anorlu RI, Oluwole A, Abudu OO, Adebajo S. Risk factors for ectopic pregnancy in Lagos, Nigeria. Aeta Obstet Gynecol Scand 2005;84:184–8.
Mollison J, Porter M, Campbell D, Bhattacharya S. Primary mode of delivery and subsequent pregnancy. BJOG 2005;112:1061–5.
Shah N, Khan NH. Ectopic pregnancy: presentation and risk factors. J Coll Physician Surg Pak 2005;15:535–8.
The management of tubal pregnancy. RCOG Guidelines No 21. May 2004. Available at: http://www.gyncph.dk/exut/rcog_management%20of%20tubal.pdf