A study on risk factors and clinical presentation of ectopic pregnancy in women attending a tertiary care centre

Aim: The present study was designed to study the ectopic pregnancy risk factors and their clinical presentation in ectopic pregnancy attending to a tertiary care center. Material and methods: It was a prospective study with 50 cases of ectopic pregnancy conducted in the Department of Obstetrics and Gynecology, Narayana Medical College and Hospital, Nellore for a period of 2 years were included. Detailed history suggestive of risk factors for ectopic pregnancy, menstrual and obstetric history was taken. General, systemic, abdominal and vaginal examination was done. Results: A total of 2777 pregnancies were confirmed during the study period, of which 50 cases of ectopic pregnancies were diagnosed, giving an incidence of 1.8%. 74% were in the age group of 21-30 years. 84% of women were multigravidae and 16% were primigravidae. 80% of the patients had identifiable risk factors, of which past history of PID in 26%, history of previous abortion in 16%, infertility in 10%, uterine anomalies in 4%, history of previous ectopic pregnancy in 6%, usage of IUCD and OCP in 6% each and tubectomy in 6% were noted. 96% had amenorrhea, followed by pain abdomen in 90%, bleeding PV in 68%, fainting and syncopal attack in 16% of the patients. Pallor in 56% of the cases, 18% presented with shock was noted. Percentage of haemoglobin was <7gm% in 28% observed. Evidence of 41 patients with ruptured ectopic were recorded. 7 were unruptured ectopics and 3 were tubal abortions recorded. Conclusion: Increasing awareness regarding safe sexual practices and contraception decrease abortions and reduces the risk of ectopic pregnancy. All high risk women should be screened at the earliest with serum β-hCG and TVS. The impact on future fertility can be improved by focusing on primary prevention and early diagnosis before rupture.