IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-9-4-24885 Original Research Paper ANALYSIS OF STRATEGIES ADOPTED IN MANAGEMENT OF ECTOPIC PREGNANCIES TO ARRIVE AT NIL MORTALITY IN TERTIARY CARE HOSPITAL Kanakannavar Dr. April 2020 9 4 01 02 ABSTRACT

INTRODUCTION: Ectopic pregnancy is a life–threatening condition. Rising trend in incidence of ectopic pregnancies necessitates awareness about risk factors, resultant morbidity and mortality. AIMS & OBJECTIVES: Aim of the study was to determine the incidence, clinical presentation, risk factors, morbidity and mortality associated with ectopic pregnancy at tertiary care hospital. MATERIALS METHODS: Retrospective analysis of ectopic pregnancy was done in dept. of OBG, Vanivilas Hospital, Bangalore medical college and research institute from Sept–2016 to Sept–2018. The following parameters: age, parity, gestational age, risk factors, clinical presentation, site of ectopic, mode of treatment and morbidity were noted. RESULTS: Out of 30725 deliveries, 294 were ectopic pregnancies (0.89 %). Ruptured were 256(87.07%) and un–ruptured were 38 (12.92%). 9 un–ruptured ectopic pregnancies ended in laparotomy.Women with age 20–30yrs had highest incidence (51.7%), more than 30yrs had (41.83%) and with least below 20yrs (6.46%). Ectopic pregnancies were common in multiparous (85.03%) women than primigravida (14.97%). Common symptoms: abdominal pain (86.04%), amenorrhea (93.87%), bleeding per vagina (5.14%), asymptomatic (6%) patients. Urine pregnancy test positive in 94.89%. etiology was pelvic infection (18.02%), infertility (7.01%), previous ectopic (8.84%), contraception (5.78%), tubal surgeries like tubectomy (11.56%, BAT 4.36% and LTO 7.20%). Right sided ectopic (67.00%) was more common. Site of ectopic: Common in fallopian tube– ampullary region (59.86%), cornual (8.16%), isthmus (12.58%), fimbria (3.74%), followed by ovarian ectopic (1.36%) then cervical (0.34%), rudimentary horn pregnancy (0.68%). About 87.07% of ectopic was ruptured, half of these patients presented with shock at the time of presentation. Tubal abortions were seen in 19.04% of patients. Most of cases being ruptured ectopic pregnancies, salpingectomy in 89.05% and salpingo–opherectomy in 1.02% was done. Morbidity was blood transfusion (87.75%), wound complications 4.76% and mortality rate was nil. CONCLUSION: Early diagnosis, identification of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.