CLINICAL TRENDS OF ECTOPIC PREGNANCY - A STUDY IN A TERTIARY CARE HOSPITAL OF WEST BENGAL, INDIA

Background: Ectopic pregnancy (EP) is the single most important cause of maternal morbidity and mortality in the first trimester and its rising trend throws a great challenge to the obstetrician and gynecologist due to its varied presentation.

Aim:  To study the incidence, clinical trends, risk factors and surgical management of ectopic pregnancy in a tertiary care hospital.

Materials and methods: Retrospective study conducted among the diagnosed cases of ectopic pregnancies admitted during a period of 3 years and a total of 474 cases were studied. Data collected from BHT, Labor ward registers, Gynae ward registrars, Operation Theatre registers, Intensive care unit (ICU) and high dependency units (HDU) records. All the parameters were tabulated and analyzed after data entry.

Results: Peak age of incidence were among 26-30 years (32.27%), more common in multigravida (74.69%), commonly presented at gestational age between 6-8 weeks (50.42%) risk factors associated with 73.18% of cases. Most commonly presented with lower abdominal pain (75.31%) followed by short h/o amenorrhea (68.35%). Classical triad presents in 37.97% of cases. Clinically extreme pallor and hemodynamically shock stage presented in 26.58% and 33.33% cases respectively. The commonest site of affection was Ampulla of the tube (50.84%) and most common operation done was Salpingectomy (83.54%). There was no mortality.

Conclusions: Early diagnosis and proper management becomes the key of success. High degree of suspicion, identification of risk factors, availability of modern investigations and timely intervention will definitely help to reduce the morbidity and mortality associated with EP.