ABSTRACT
Introduction: Ectopic pregnancy is a common life-threatening gynaecological surgical emergency. It’s incidence is rising globally. It remains a major cause of morbidity and mortality in early pregnancy. The present study is aimed to determine the incidence, risk factors, clinical presentation, diagnosis, management and post-operative outcome of ectopic pregnancies in a tertiary care teaching hospital. Methods: The study was a retrospective study carried out in the Department of Obstetrics and Gynaecology, B.P Koirala Institute of Health Sciences, Dharan, Nepal. Data were retrieved from the medical record section, from the case sheets of gynae admission registers and operative notes in the study duration of one year (January 2019-December 2019). The gynaecological admissions and records of the total births within the period of study were also used in the analysis. Results: During this study period, the incidence of ectopic pregnancy was 0.95% of total births and 7.46% of the total gynaecological admissions. The peak age group of incidences was age of 26-30 years. Use of contraception and history of abortion were the main risk factors with contributions of 27.82% each respectively. Abdominal pain (86.95%), amenorrhoea (81.73%), vaginal bleeding (54.78%) were the most frequent presenting complaints. Ampulla (58.26%) followed by cornua (8.69%) were the commonest sites of ectopic implantation. Ovarian pregnancies contributed to only 5.21%. A total of 69.56% patients presented with ruptured ectopic pregnancy but only 14.78% had hemodynamic instability. In majority of patients salpingectomy (61.73%) was done followed by salpingo-oophorectomy (8.69%). Only 11.30% received methotrexate in line of medical management and 59.13% required blood transfusion. There was no maternal mortality. Conclusions: Early diagnosis, timely referral, improved access to health care facility and aggressive management would help to reduce the maternal morbidity and mortality associated with ectopic pregnancy.
Keywords: Blood transfusion, ectopic pregnancy, risk factors, salpingectomy.