Clinical profile and outcome in ectopic pregnancy in a teaching institution: A prospective observational study.

Abstract

Ruptured ectopic pregnancy is a leading cause of maternal mortality in the first trimester. Nowadays, with better diagnostic and therapeutic modalities available, the mortality due to the ruptured ectopic pregnancy has reduced, but the effect of various treatment options on subsequent fertility of women remains unclear. Hence, this study was planned to evaluate the clinical profile and outcome of various treatment options in women presenting with ectopic pregnancy. This was a prospective observational study conducted in the department of Obstetrics and Gynecology, J.N.M.C.H., Aligarh for a period of 2 years. Total 100 cases diagnosed with ectopic pregnancy were included in the study. After detailed history and clinical examination, decision of management (expectant, medical or surgical) was taken according to the hospital protocol. The patients were then followed-up throughout their treatment course. Data was analyzed by frequency, percentage, and Chi-square test. Most common age group of patients with ectopic pregnancy, in our study was 20-25 years. Out of 100 patients enrolled, 82% had some underlying risk factor, most common being pelvic infection, seen in 30% cases. The classical triad of abdominal pain, amenorrhea and vaginal bleeding was present in 52 patients. Majority of patients in our study were managed by surgery i.e. 78%; 18% were treated medically and 4% underwent expectant management. Most of the patients with ectopic pregnancy, in our study were in early twenties with pelvic inflammatory disease being the commonest risk factor and abdominal pain as commonest symptom. Although, medical therapy offers safe and effective alternative for management of tubal ectopic, in our study most patients were managed surgically. The treatment approach depends upon clinical presentation and has impact on the future fertility.