MANAGEMENT OF ECTOPIC PREGNANCY: A TWO-YEAR STUDY
AbstractBackground: Ectopic pregnancy is the most important cause of maternal mortality and morbidity inthe first trimester. Over the past few decades, the management of ectopic pregnancy has beenrevolutionized; various modalities of treatment are currently in practice. The purpose of this studywas to determine the frequency of these modes of treatment of ectopic pregnancy and their outcome.Methods: Fifty two patients diagnosed to have ectopic pregnancy at MCH Center unit II in the year2004 and 2005 were included in the study. A cross-sectional analytical study was done. Four modes oftreatment were given according to patient’s condition, ultrasound findings and ß-hCG levels; thesewere laparotomy, operative laparoscopy, methotrexate injection and conservative management. Theoutcome measures included success of each treatment modality, need for second mode of treatment ineach group and duration of hospital stay. Results: A total number of 52 patients with ectopicpregnancy were identified and studied. The rate of ectopic pregnancy was 1:100 deliveries.Emergency laparotomy was performed in 30 (57.9%) women, 15 (28.8%) received methotrexateinjection. Seven women (13.3%) were managed conservatively and operative laparoscopy was notused as primary treatment in any of the patient. All cases of laparotomy did not require any furtherprocedure. Twelve out of fifteen (80%) cases of medical treatment were successful while one (6.7%)proceeded to emergency laparotomy, one (6.7%) to operative laparoscopy and one (6.7%) tolaparoscopy preceding laparotomy. Five out of seven patients (71.4%) on conservative treatment didnot require any further intervention while two (28.6%) of them resolved with methotrexate injection.The duration of hospital stay in laparotomy, medically treated and conservatively managed groupswas 6.5, 5.9 and 1.7 days respectively. Conclusion: In the institutional setting ectopic pregnancyaccounted for 1% of total deliveries. More than half of all women with ectopic pregnancy presentedwith acute abdomen and required emergency laparotomy. About 40% women could be managed withnon-surgical modalities with 80% success for methotrexate injection and 71% for conservativetreatment in the present study.Keywords : Ectopic pregnancy, methotrexate, laparoscopy.
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