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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 14, Issue 3, April 2015 pp 563-566
Ectopic pregnancy: A retrospective analysis of 100 cases in a tertiary care centre
Assistant Professor, Department of Obstretrics and Gynaecology, Mysore Medical College, Mysore, Karnataka, INDIA.
Introduction: Ectopic pregnancy (EP) is one of the causes of maternal mortality and morbidity in the first trimester. The aim of this study was to emphasise on risk factors, clinical presentation and the management of these cases. A retrospective study of 100 cases was undertaken in our tertiary care centre from 01/01 2013-31/12 2014. Material and Methods: One hundred patients with provisional diagnosis of ectopic pregnancy were studied. Clinical findings, urine pregnancy test, ultrasonography findings (transabdominal/transvaginal) and culdocentesis were done. The diagnosis was confirmed by laparotomy. Results: The peak age of incidence was between 20-25 years 46%, followed by >30yrs in 21%.Multigravidas, especially second gravida were commonly affected. Previous tubectomy was the risk factor seen in 25% of cases, then previous history of abortion in 21% cases. More than one risk factor was present in each case. Most of them presented with the classical triad, pain abdomen (91%), amenorrhea (80%) and vaginal bleeding (59%). Shock and hypotension was seen in 12% of cases. Urine pregnancy test was positive in all the cases and ultrasonography showed adnexal mass in 64 cases, hemoperitoneum in 59 cases. Laparotomy was done in all 100 cases. Tubal pregnancy was seen in 98%, one ovarian and one in rudimentary horn. Right tube was commonly affected in 59 cases and rupture was seen in 68 cases. Salpingectomy was done in 86 cases and blood transfusion was required in 43 cases. One patient developed DIC and treated with component therapy. No maternal mortality among these cases. Conclusion: High degree of suspicion, early diagnosis and early intervention are essential in the management of Ectopic pregnancy to reduce morbidity and mortality of this obstetric emergency. Ultrasonography is the gold standard which is a non-invasive diagnostic test and helps in early intervention.