Clinical presentation, risk factors and management of ectopic pregnancy: a case-control study

A Lavinia Cozlea,E Előd Élthes,M Emil Capîlna,Á Török

doi:10.12891/ceog4891.2019

Abstract

Purpose of Investigation: To evaluate risk factors in patients with ectopic pregnancy (EP), while emphasizing the clinical presentation and management. Materials and Methods: Eighty patients with EP were included in a retrospective case-control study between 2016-2017. Patient’s socio-demographic features and pathological background were assessed in relation to 150 patients with live vaginal deliveries, in order to determine the main risk factors for EP. Results: Tubal (95%) was observed, with right side (60%) preponderance of EP, associated with vaginal bleeding (80%) and leukocytosis (61.25%). Main identified risk factors were previous EP (OR = 11.79), cesarean section (OR = 11.31), cigarette consumption (OR = 7.47), history of laparotomy (OR = 7.28), and tubal damage (OR = 7.09). Most patients underwent laparoscopy (87.5%) associated with a shorter hospital admission (p = 0.0011). Conclusion: Considering the risk factors, the physician could establish an accurate diagnosis in less time, avoiding complications by performing a suitable surgical intervention.

Highlights

Ectopic pregnancy (EP), known as extra-uterine, is defined as a condition in which the blastocyst is implanted outside the uterine cavity and about 95% having the fallopian tube as implantation site
The retrospective study conducted during 2016-2017 followed 80 women with EPs considering the clinical presentation, laboratory exams, and surgical management of the case, whose risk factors were gathered from the medical records and were statistically analyzed in relation to a control group (CG) of 150 women with term vaginal deliveries
Most included subjects (98.75%) had amenorrhea < 14 weeks, abdominal pain was present in 66.25% of cases, a minimum of vaginal bleeding was found in more than a half of patients (66.25%), the ratio of patients who presented any amount of vaginal bleeding was significantly higher (80%)

Summary

Introduction

Ectopic pregnancy (EP), known as extra-uterine, is defined as a condition in which the blastocyst is implanted outside the uterine cavity and about 95% having the fallopian tube as implantation site. EPs account for 1-2% of reported pregnancies, being often an emergency diagnosis in women describing acute pelvic pain or abnormal vaginal bleeding [1, 2]. A certain etiology of EP remains unknown despite the many identified risk factors, but which vary depending on the demographic characteristics [3]. Among the identified risk factors for EP in previous studies, mentioned are age, smoking habits, abortion history, tubal pathologies, prior abdominal surgeries, history of EP, infertility, advanced reproductive technologies (ART), even endometriosis [4]. This study analyzes the main risk factors in women with EPs, together with demographic features, clinical and laboratory findings, and surgical management of these implanted pregnancies

Methods

Results

Discussion

Conclusion