A retrospective analysis of ectopic pregnancy in a tertiary care centre in South Kerala

Abstract

Introduction : Ectopic pregnancy means the presence of pregnancy outside the normal uterine cavity. Ectopic pregnancy commonly occurs in the fallopian tube (95 %). Diagnosis can be made by USG, serum hCG, although the gold standard is laparoscopy. Management of the cases depends on the clinical presentation, site of the ectopic and need for future reproductive function and can be medical as well as surgical. Objectives : To determine the incidence of ectopic pregnancy, to assess the percentage of ectopic pregnancy diagnosed with each modality, to identify the factors associated with ectopic pregnancy and to calculate the type of management employed whether medical or surgical. Material and methods : This is a retrospective study where all the cases of ectopic pregnancies 1^st January 2008to 31^st December 2013 were included. The data on each patient was obtained and was duly entered in M S Excel and descriptive statistical measures were used for analysis Results : The incidence of ectopic pregnancy in the present study was 0.7%. 33.3% patients were primigravida. 5.5% had history of recurrent abortions, 11% of the patients took treatment for infertility, 27.7% had history of previous LSCS, Dand C was done in 13% patients and 31.5% had undergone sterilization.In 83.3% ectopic gestation was diagnosed by ultrasound whereas rest 16.7% was diagnosed by serial serum hCG estimation. 22.2% underwent medical management rest 89% patients underwent surgical management. Failure of medical therapy and subsequent surgical management was seen in 50% patients. Conclusions : Ectopic pregnancy causes significant morbidity to the mother and hence requires a high index of suspicion so that diagnosis can be made early and also to prevent complications and preserve the future reproductive function of the patient.