A Study to Assess Ectopic Pregnancy Profile and Outcome: An Observational Assessment

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, Patna Medical College and Hospital, Patna, Bihar, India for 10 months. Total 110 cases were diagnosed with ectopic pregnancy. Results: During the study period, 42000 deliveries and 110 ectopic pregnancies. The most common site of ectopic pregnancy was fallopian tube 97(88.18%). Ampulla was the commonest site 75(68.18%) 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(2.73%) cases of heterotopic pregnancies. The most common risk factor was pelvic inflammatory disease 50(45.45%) followed by H/o previous abortion 21(19.09%) and H/o previous abdominopelvic surgery including tubal ligation, LSCS and appendicectomy 33(30%). 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, 18(16.36 %) 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. In the present study, urine pregnancy test was positive in 105(95.45%) of patients. Culdocentesis was positive in 47(42.73%) of patients. Ultrasound was able to diagnose 91(82.73 %) of cases. USG findings suggestive of ectopic pregnancy were extra-uterine gestational sac 17(115.45%), haemoperitoneum 64(58.18%) and adnexal mass 83(75.45%). Conclusion: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.