An evaluation of management modalities and outcomes of ectopic pregnancy

Abstract

Objectives: To describe the role of early diagnosis, outcomes of medical and surgical management of ectopic pregnancy. Methods: A prospective observational study was conducted for one and half years, on women with an ectopic pregnancy. Demographic, medical, gynecological and obstetric details were noted. Standard criteria were followed for conservative management and the others underwent surgery. Outcomes studied included status of rupture of the tube, presence or absence of shock, need for blood transfusion, operative procedure performed, post-operative morbidity, time for resolution of beta-hCG and success of medical management. Appropriate statistical analysis was performed using percentages and chi-square tests. Results: 40 patients were studied in the time period with an average of 27.6 years. There were more multigravidae (78%) in the study, and majority of the patients (80%) had atleast one risk factor. Larger proportion of patients presented with ruptured ectopic status (55%), and they belonged to a more advanced gestational age. Though medical management was offered in 40% of the patients initially, 15% required conversion to surgical management. Conclusions: Ectopic pregnancy continues to be a problem with significant morbidity. Multigravidae of younger presenting at a later gestational age appear to have a higher magnitude of the problem.

Keywords

• ectopic pregnancy
• beta-hcg
• conservative management
• methotrexate