Clinical study of ectopic pregnancy in tertiary care centre

Author(s): Dr. Mohini Ahirwar1, Dr. Pallavi Singh2, Dr. Rubina Dohare1
1PG Resident, Department of Obstetrics and Gynaecology Gandhi Medical College, Bhopal.
2Associate Professor, Department of Obstetrics and Gynaecology, Gandhi Medical College, Bhopal.
Copyright © Dr. Mohini Ahirwar, Dr. Pallavi Singh, Dr. Rubina Dohare. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Ectopic pregnancy (EP) is a condition presenting as a major health problem for women of childbearing age. This study aimed to identify potential risk factors for EP and to evaluate the contribution of the risk factors associated to EP.
Material and Methods: The present Prospective (Hospital based) Observational study was conducted in the Department of Obstetrics and Gynaecology, Gandhi Medical College, Bhopal. After approval from institutional ethical committee for a period of 18 months from January 2021 to June 2022. All diagnosed cases of ectopic pregnancy during 18 months of study period in GMC Bhopal. The diagnosis of ectopic pregnancy was made by detailed history, clinical examination, laboratory evidence (urine pregnancy test/serum beta HCG), and radiological investigations (ultrasound).
Results: In our study 65.0% of the patients were from the age group of 21-30 years, 63.6% of the patients were multigravida, 48.6% patients belonged to low socio-economic status, 55.7% were educated, 50% cases were less than 7 weeks of gestation ,and 45.7% patients were between 8-14 weeks of gestation, 8.6% patients had undergone sterilization, while 2.1% were using IUCD, Majority of ectopic pregnancy occurred in fallopian tube i.e., 124 (88.57%) followed by Ovary in 10 (7.1%) patients. Rudimentary horn ectopic pregnancy was witnessed in 5 (3.6%) patients. In our study 111 (79.3%) patient presented with ruptured ectopic pregnancy to the department, while the rest 21.7% were unruptured. surgical intervention done in 133 individuals, accounting for 95.0% of the sample, whereas the remaining 7 participants (5.0%) received medical treatment.
Conclusion: Ectopic pregnancy can be life-threatening. Hormonal assays, transvaginal sonography, and laparoscopy are detecting ectopic pregnancies early, increasing their incidence. Reproductive organ mutilation can affect fertility. Tubal surgery, PID and abortions increase ectopic pregnancy risk. In patients without risk factors, early diagnosis is critical. Antenatal care facilities should have USG, particularly transvaginal sonography (TVS), and trained staff. Early detection of first-trimester complications like ectopic pregnancies reduces mortality. As the incidence of ectopic pregnancy has been on the rise, screening of high risk cases, early diagnosis and early intervention are required to enhance maternal survival and conservation of reproductive capacity.

Keywords: Ectopic pregnancy; intrauterine device; tubal damage.