Prospective Observational Assessment of Ectopic Pregnancy Incidence, Risk Factors, Clinical Characteristics, Diagnosis, Management and Outcome

Aim: The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology, Lady Harding Medical College, Delhi, India, for 15 months . Total 100 cases were diagnosed with ectopic pregnancy. Results: During the study period, 39000 deliveries and 100 ectopic pregnancies. Therefore, the incidence of ectopic pregnancy (0.024%) or 2.4 per 1000 deliveries. The most common site of ectopic pregnancy was fallopian tube 88(88%). Ampulla was the commonest site 67(67%) for ectopic implantation in the fallopian tube. Heterotopic pregnancy is rare where pregnancy is seen in the uterus and tube at the same time. In our study, there were 3(3%) cases of heterotopic pregnancies. The most common risk factor was pelvic inflammatory disease 44(44%) followed by H/o previous abortion 20(20%) and H/o previous abdominopelvic surgery including tubal ligation, LSCS and appendicectomy 23(23%). Although any form of contraception decreases the overall risk of pregnancy including ectopic Pregnancy, when contraceptive failure occurs in women using an IUCD or following tubal sterilization, risk of Ectopic Pregnancy is elevated. In our study, 13(13 %) patients were using copper IUCD. H/o infertility due to tubal block or other causes, treatment associated with infertility, endometriosis and H/o previous ectopic pregnancy were other identified risk factors. Conclusion: The incidence of ectopic pregnancy is on the rise. The incidence of ruptured ectopic pregnancy is high in developing countries due to late diagnosis and delayed referral. In developing countries, PID and postabortal sepsis continue to be the most important risk factor for ectopic pregnancy.