Publication: Ectopic pregnancy – Two years review from BPKIHS, Nepal
Date
2005
Authors
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Journal ISSN
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Publisher
Kathmandu University
Abstract
Ectopic pregnancy remains an important cause of morbidity and mortality in early pregnancy. The incidence has
increased worldwide with an increase in pelvic infections and improvements in the diagnostic techniques. The
objective of this study was to analyse the various aspects of ectopic pregnancy with a view to suggest interventions
which would decrease the incidence.
Material and methods: The study was carried out in the department of Obstetrics and Gynaecology, B.P Koirala
Institute of Health Sciences, Dharan (Nepal). Data were analysed retrospectively using the case sheets and operative
notes from the past two years (April 02-April 04). The gynaecological admissions and records of the total births
within the period of study were also used in the analysis.
Result: The incidence of ectopic pregnancy during this study period was 0.93 of total births and 2.92% of the total
gynaecological admissions. The peak age of incidence was in the range of 26-30 years. Majority of patients were in
the lower socioeconomic group. Pelvic inflammatory disease and induced abortions were the major risk factors.
Their contribution was 61.3% and 38.6% respectively. 70.6% of patients did not use any contraception. 16% used
depo provera. Abdominal pain (69.3%), vaginal bleeding (45.3%) and syncopal attacks (21.3%) were the most
frequent presenting complaints. 58.6% had amenorrhea of 6-10 weeks. Only 1.3% presented with amenorrhea of
greater than 10 weeks. Ampulla (62.6%) followed by isthmus (21.3) were the commonest sites of ectopic
implantation. Ovarian and abdominal pregnancies contributed to only 1.3% each. There was no significant
difference between the side of the tube involved.82.6% had come with ruptured ectopic but only 12% were in shock.
Majority of patients underwent salpingectomy (69.3%) followed by salpingo-oophorectomy (17.3%). Only 2.6%
received methotrexate. 70.6% required blood transfusion.
Conclusion: Majority of patients attending BPKIHS for ectopic pregnancy were between 26-30 years and had
history of PID & induced abortions. Surgery (salpingectomy/salpingo-oophorectomy) was the main stay of
treatment.