Clinical Perspective of Ectopic Pregnancy in a Tertiary Care Hospital in Karnataka, India

OBJECTIVES (1) To know the age group, parity and the risk factors with respect to ectopic pregnancy. (2) To know the clinical presentation of ectopic pregnancy. (3) To know the outcome of ectopic pregnancy. MATERIALS AND METHODS This is a retrospective study conducted in Kempegowda Institute of Medical Sciences and Research Centre, Bengaluru, India. Data was collected regarding 45 cases with ectopic pregnancy from December 2014 to January 2017. and parameters including age, parity, gestational age, risk factors, clinical presentation, need for transfusion of blood products, findings on ultra-sonogram and at surgery, duration of hospital stay and associated morbidity were assessed. RESULTS There was a significant association of ectopic pregnancy with risk factors, most common of which were a history of infertility and abortion (s). The classical triad of pain abdomen, amenorrhoea and vaginal bleeding were not seen in all cases. Pain was the most common presenting symptom seen in 93 % of cases, followed by amenorrhoea in 84 % of cases. Vaginal bleeding was seen in only 38 % of cases. The most common signs encountered were pallor (82 %) and abdominal tenderness (77.7 %). Surgery by open method was the most common form of treatment. The commonest site of ectopic pregnancy was ampulla and there was haemoperitoneum in 93 % of cases. CONCLUSION Ectopic pregnancy can present in any form within a wide clinical spectrum and a high index if suspicion is mandatory with regard to history and clinical features. A preliminary investigation with a urine pregnancy test and an ultrasound is minimally invasive and appears to be adequate to diagnose a majority of ectopic pregnancies. Surgical intervention remains the mainstay of treatment and there appear to be minimal post-operative complications.