A One year prospective study of Ectopic Pregnancies in a Tertiary Medical College Situated in rural area of Tamil Nadu

Abstract

Background: Ectopic pregnancy is an obstetric emergency which can cost a life if timely intervention is missed. It is one of the causes of morbidity and mortality in first trimester. The aim of this study is to analyse the risk factors, clinical profile, management and outcome of ectopic pregnancy.Materials and Methods: The study was conducted at Rajah Muthiah Medical College and Hospital, Chidambaram over a period of one year from July 2019 to June 2020 in the Department of Obstetrics and Gynaecology. In the study, 76 patients with ectopic pregnancy were observed for various risk factors, clinical profile, appropriate management done and outcome studied.Results: In my study, the incidence of ectopic pregnancies was found to be 1.26 percentage of total deliveries. In my study, risk factors like pelvic inflammatory diseases was seen in 15 patients (19.7%), treatment for subfertility (ovulation induction) was seen in 9 patients (11.8%), history of previous abortions was seen in 24 patients (31.6%), history of previous ectopic pregnancy was seen in 6 patients (7.9%), history of PPIUCD in 2 patients (2.6%), history of Tubectomy was seen in 11 patients (14.5%), history of previous caesarean section in 37patients (28.12%). The most common presenting complaint was lower abdominal pain seen in 90.8% of patients. Lower abdomen tenderness was present in three fourth of the study population. Cervical motion tenderness was present in 82.9% of patients. Medical management with methotrexate was done in 10 patients and the remaining patients were managed surgically. The most common site of ectopic pregnancy was ampulla 64.2%. The most common procedure done was partial salpingectomy in 76.1%. There was no mortality in the study.Conclusions: The chance of ectopic pregnancy is high in the presence of risk factors. Patients with ectopic pregnancy most commonly present with lower abdomen pain and amenorrhoea. Lower abdomen tenderness and cervical motion tenderness were the most common examination findings. Ampulla was the most common site of ectopic pregnancy. The success rate of medical management with methotrexate was found to be 90%.