Rajani M1, Jayasree S2, Smitha Sreenivas K3
ABSTRACT: INTRODUCTION: Ectopic pregnancy is still the leading cause of maternal death in the first trimester. It is a nightmare for the obstetrician Globally, there is an increased incidence of ectopic pregnancy due to the increase in the incidence of sexually transmitted diseases, increase in the prevalence of ART procedures and tubal reconstruction surgeries. OBJECTIVES: Aim of the study was to find out the incidence of ectopic pregnancies the risk factors and to find out the relation between ectopic pregnancy and family planning practices and to evaluate the clinical presentation, methods of management and outcome. SETTINGS: A prospective descriptive study was conducted in the Institute of maternal and child health, Government Medical college, Kozhikode, Kerala, for a period of one year from 01/01/2013 to 31/12/2013. All patients with ectopic pregnancy and pregnancy of unknown location attending our OP and casualty were included in the study. RESULTS AND CONCLUSION: There were 270 cases of ectopic pregnancies during the study period of one year. Total number of deliveries during the period was 15727 thus giving an incidence of 1.72% of total deliveries. Mean age of presentation was 29±1. 90.3% of them were multigravidas. 69.4% of them had some risk factors identified and 30.6% had no risk factors. There were 50 cases of sterilization failures during this period. 40 cases presented with ruptured ectopic and only 10 cases were intrauterine. Among the risk factors identified, sterilization, infertility and genital infection topped the list. 68% of them had an acute presentation and 6.2% of them were brought in shock. 49.6% of them had laparotomy and surgical management. All surgically managed patients had a hospital stay of <1 week and conservatively managed had a stay of >1 week. There was no mortality in the present study. Theoretically, all women are at risk of ectopic pregnancy. Those with some risk factors are having a much higher risk. Risk factors may not be always present Hence ectopic pregnancy should be suspected in any woman of reproductive age group who presents with unexplained abdominal pain and or vaginal bleeding.
