OBJECTIVE: To observe the risk factors, clinical pattern and management of ectopic pregnancy.
DESIGN: Descriptive observational study.
PLACE AND DURATION: Gynecological Unit II, Liaquat University of Medical and Health Sciences,
Hyderabad from January 1st 2006 to April 1st 2008.
PATIENTS & METHODS: All patients with confirmed diagnosis of ectopic pregnancy were included
in the study. A pre-formed proforma was used to record the details about the demographic
features, pre-existing risk factors for ectopic pregnancy, clinical features at presentation,
management and findings at surgery. Data fed to SPSS program version 11 to analyse the
results in terms of frequency and percentages.
RESULTS: Total maternity admissions were 8016 with 62 cases of ectopic pregnancy giving an
incidence of 0.8% or 1:129. Mean age was 24 years. Majority of the patients were of low parity
(n=34, 54.8%). Pelvic inflammatory disease (n=22, 35.4%), previous abdomino pelvic surgery
(n=16, 26%), previous ectopic (n=4, 6.4%) and infertility (n=22, 35.4%) were seen as the major
risk factors. Regarding the clinical pattern; abdominal pain, amenorrhea and collapse appeared
as the common clinical presentations. All patients required surgery. Open laparotomy was performed
in 56 (90.3%) cases while 6 (9.7%) patients managed laparoscopically. None of the patients
found suitable for conservative or medical management. There was no maternal death
related to ectopic pregnancy and the postoperative recovery was uneventful.
CONCLUSION: The classic clinical pattern of amenorrhea and abdominal pain was lacking in
most of the cases with ectopic pregnancy and there were initial diagnostic difficulties. Pelvic
inflammatory disease and history of infertility were the main risk factors. Due to the delay in
making diagnosis at early stage, open surgery was required in all cases. This emphasizes the
importance of a thorough clinical evaluation and appropriate investigations for patients with
high suspicious to benefit our poor patients by the use of recent therapeutic modalities
Key words: Ectopic pregnancy, surgical intervention, infertility.