Ectopic pregnancy - two years review from BPKIHS, Nepal

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Public Health

Background:

• Ectopic pregnancy is a leading cause of maternal morbidity and mortality in early gestation.
• Global incidence is rising due to increased pelvic infections and enhanced diagnostic capabilities.

Purpose of the Study:

• To analyze various aspects of ectopic pregnancy.
• To identify interventions for reducing ectopic pregnancy incidence.

Main Methods:

• Retrospective analysis of case sheets and operative notes from April 2002 to April 2004.
• Inclusion of gynecological admissions and total birth records for incidence calculation.

Main Results:

• Ectopic pregnancy incidence was 0.93% of total births and 2.92% of gynecological admissions.
• Peak incidence occurred in women aged 26-30, often from lower socioeconomic groups.
• Major risk factors included pelvic inflammatory disease (61.3%) and induced abortions (38.6%); 70.6% used no contraception.
• Common symptoms were abdominal pain (69.3%) and vaginal bleeding (45.3%).
• Most common implantation site was the ampulla (62.6%).
• 82.6% presented with ruptured ectopic pregnancy, but only 12% were in shock.
• Salpingectomy (69.3%) was the predominant surgical procedure.

Conclusions:

• Ectopic pregnancy predominantly affects women aged 26-30 with a history of pelvic inflammatory disease and induced abortions.
• Surgical interventions, primarily salpingectomy or salpingo-oophorectomy, remain the mainstay of treatment.