Ectopic pregnancy  An experience in Medical hospital and Research Institute

Dr.Malathi T; Dr. Kanmani T.R; Dr.Sowmya K; Dr.Smitha K

Volume : IV, Issue : VI, June - 2015

Ectopic pregnancy An experience in Medical hospital and Research Institute

Dr. Malathi T, Dr. Kanmani T. R, Dr. Sowmya K, Dr. Smitha K

Abstract :

Introduction: Ectopic pregnancy is an obstetric emergency which is increasing in incidence. There are many risk factors associated with ectopic pregnancy and tubal damage is the most common factor. Women with ectopic pregnancy can have varied clinical presentation. Diagnosis is made from clinical presentation, beta HCG and ultrasound. Early diagnosis is the key for medical management and conservative surgery. Objectives: To study the risk factors, clinical presentation and management of ectopic pregnancy. Methods: Data was collected retrospectively from the case records of women admitted with the ectopic pregnancy over the period of five years. Results: 104 patients were admitted with the diagnosis of ectopic pregnancy. 33.5% of the patients were in age group of 25–29 yrs. 29% of the women were primigravida. The risk factors associated were prior surgeries in 27.9%, history of medical and surgical abortion in 17.3% and 11.5% respectively. 7.85% of the women had prior ectopic pregnancy. 14.4% of patients had undergone tubal sterilization. The classical symptom of amenorrhea, pain abdomen and bleeding per vagina was present in 24.03%. 31.8% of the women had amenorrhea and pain abdomen and 1% had uterine bleeding alone. Abdominal tenderness was present in 75% and abdominal distension in 24% of patients with ruptured ectopic pregnancy. 13.5% of women presented with adnexal mass while tenderness was present in 38.5%. 5.8% had undergone medical management, one of the them failed. 86.5% underwent surgical treatment. The site of ectopic was ampullary region in 25% and tubal abortion in 25%. Conclusion: Ectopic pregnancy can affect any woman in the reproductive age group irrespective of contraception and tubal sterilization and even in the absence of risk factors. It is very essential to sensitize the junior doctors in the emergency department. Emphasis should be done in the clinical posting which will help during the internship. Early diagnosis is essential for conservative treatment and will also reduce the need for blood transfusion. Many of the clinicians fail to give importance to the patients� and their care givers� psycho social needs, which need to be tailored along with the counseling unit in the department or in the hospital