Evaluating the Frequency, Risk Factors, Clinical Characteristics, Diagnosis, Treatment, and Outcome of Ectopic Pregnancies: Observational Research

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, Nalanda Medical College and Hospital, Patna, Bihar India for 15 months. Total 50 cases were diagnosed with ectopic pregnancy. Results: The mean age of the patients was 27.97±5.25years. Majority of the patients 26 (52%) belonged to 20-25 years. Most of the patients 32 (64%) belonged to lower class socioeconomic status. Majority of the patients 37 (74%) were multiparous and 7 (14%) of the patients were nulliparous. The most common site of ectopic pregnancy was fallopian tube 46 (92%). The most common risk factor was pelvic inflammatory disease 24 (48%) followed by H/o previous abortion 11 (22%) and H/o previous abdomino pelvic surgery including tubal ligation 8 (16%) and LSCS 4 (8%). Almost 95% patients in our study came with H/O variable period of amenorrhoea. 44 (88%) cases complained of abdominal pain. 66% of the patients had bleeding or spotting per vaginum. The other symptoms noted in our study were syncope 15 (30%), nausea / vomiting 19 (38%) and urinary symptoms 11 (22%). In our study, 48 (96%) of patients had severe pallor. The most important signs which guided in the diagnosis of ectopic pregnancy were cervical excitation pain 36 (72%), abdominal tenderness 33 (66%), adnexal mass or fullness 30 (60%) and tenderness in the fornix 34 (68%). Urine pregnancy test was positive in 95% of patients. Culdocentesis was positive in 42% of patients.97% patients underwent laparotomy (unilateral or bilateral salpingectomy or salpingoophrectomy). 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.