Diagnosis and management of cases of ectopic pregnancy in a tertiary care centre: our experience

Background: Ectopic pregnancy is a leading cause of maternal morbidity and mortality. With our study, we aim to highlight the importance of risk factors and effect of clinical presentation on the management modalities of ectopic pregnancy and study changing trends of modern management from radical surgical methods to medical and laparoscopic management of ectopic pregnancies. Methods: This prospective study was undertaken at a tertiary care hospital between May 2021 and May 2022. Results: The most common age group of presentation was 26-30 years. The most common risk factor was history of previous abortion. Amenorrhoea and abdominal pain were the most commonly encountered symptoms in this study. Cervical motion tenderness was significantly associated with ruptured ectopic pregnancy. Conservative medical management with injection methotrexate (Mtx), which was successful in 50% cases. Success rate was 100% for laparoscopic management and 100% for laparotomy in this study. No maternal mortality was observed during the present study. Conclusions: Our hospital being a tertiary centre, had to manage a number of cases as surgical emergencies by laparotomy and not conservatively, as they brought in either diagnosed cases of ruptured ectopic pregnancy, or failure of medical management. It is important that in the face of this diagnostic dilemma, all physicians should be should maintain a high level of suspicion and be sensitive to the fact that in the reproductive age group any woman presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be considered irrespective of the presence or absence of amenorrhea or tubal sterilisation.