A retrospective study of ruptured tubal ectopic pregnancy managed by open and minimal invasive surgery

Abstract

Ectopic pregnancy is a serious hazard to a woman’s health and requires prompt attention and early aggressive intervention. These complications are not only fatal loss but also causes significant maternal morbidity and mortality. Minimal invasive surgery is considered to be safest effective surgical solution for tubal ruptured ectopic pregnancy to reduce intra operative blood loss, analgesic requirements and hospital stay. A clinical retrospective study in an academic tertiary obstetrics and Gynaecology department of Pradyumna Bal Memorial hospital, Kalinga Institute of medical science (KIMS), Bhubaneswar, Odisha was conducted in the period of three years. A total of 90 confirmed case of ruptured tubal ectopic pregnancies were divided into 2 groups, laparoscopy(n=68) and laparotomy (n=22). The main outcome measures the demographic features like age, gravida, parity, previous spontaneous loss, previous MTP, Hb at admission, period of gestation, total blood loss and haemoperitonium and post-operative parameters blood loss, blood requirement and duration of hospital stay. No significant differences observed in age, gravida, parity, previous history of spontaneous loss and previous MTP in both laparoscopy and laparotomy procedure. Common demographic features were age (30 to 32 years), gravida (2-3) and parity (1). Patients with heavy blood loss >1000ml and massive hemoperitoneum were also undergone for laparoscopic procedure. Hospital stay and PRBC blood transfusion were less in patient undergone laparoscopic surgery. Laparoscopy is considered to be advantageous over laparotomy in terms of shorter hospital stay and speedy recovery and even in massive haemoperitoneum.