Clinicosociodemographic Profile of Ruptured Ectopic Pregnancies at a Tertiary Care Centre

Background Rupture of an ectopic pregnancy remains the most dreaded complication of a pregnancy related event and is the commonest cause of maternal mortality in the first trimester of pregnancy. In the developing countries, the maternal death rate among patients admitted with ectopic pregnancy was found to be as high as one in ten. In addition to high risk for mortality, rupture of an ectopic pregnancy could affect future fertility of a woman. The objectives of this study are to analyse the sociodemographic and clinical characteristics and find out the incidence rate and risk factors associated with ruptured ectopic pregnancies in a tertiary care institution. Methods This is a retrospective study and was conducted over a period of 6 months from November 2015 to May 2016 in Department of Obstetrics and Gynecology at Nalanda Medical college and hospital, Patna, India. It is a tertiary care centre. During this time frame a total of 1232 deliveries have taken place and 28 cases of ectopic pregnancies were reported, out of which 24 cases presented with ruptured ectopic prgnancy. Data were collected in a preconceived format and the software SSPS 15 was used for analysis. Results Total numbers of vaginal deliveries were 1232 during the study period. Out of which 28 (2.27 %) were found to be ectopic pregnancies and 24 (1.94 %) were diagnosed as ruptured ectopic pregnancies. Maximum number of patients (71.4 %) were between 21 and 30 years of age. As far as parity is concerned only 14.2 % of patients were primigravida where as 85.7 % patients were multigravida. Previous history of pelvic inflammatory disease was associated among maximum number of cases i. e 53.5 % of total number of cases. Among other risk factors, previous abortions, previous ectopic pregnancies and history of infertility treatment were the prime ones. Maximum number of patients were from lower and lower middle class socioeconomic status. Ampullary type of Tubal ectopic pregnancies were found to be the commonest ones Two cornual pregnancies and one ovarian pregnancy was also found in this study. In 85.71 % of patients the amount of hemoperitoneum was found to be more than 500 ml. Conclusions There is high incidence rate of ectopic pregnancy and low rate of diagnosis before rupture occurs in developing nations as in our scenario. Pelvic inflammatory disease, maternal education, socioeconomic status, parity and history of subfertilty are the risk factors associated with ruptured ectopic pregnancy. Effective efforts should be taken to encourage the level of education and improve the rate of diagnosis among health care providers before the occurrence of rupture.