Changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH

Background: An ectopic pregnancy occurs outside the uterus and is a relatively common condition among women of childbearing age. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death. The aim of the study was to evaluate the changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH. Methods: This study was undertaken among the patients admitted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital during the period from October 2012 to March 2013. Clinical evaluation of cases of ectopic pregnancy in terms of sociodemographic factors, presentations, risk factors, examination findings, per operative findings and management offered to the patients. The period from Data was entered in MS Excel and Statistical analysis was done using SPSS-24. Results: Most of the patients were 20-30 years age group and mean age was 28.08±4.24 years. The frequency of ectopic pregnancy was 7.60%.  High incidence was found among 0-1 parity (48%) and from a lower socioeconomic status. Commonest presentation was lower abdominal pain (94%), amenorrhoea (100%), P/V bleeding (38%) and syncopal attack (48%). Most of the cases was without contraceptic coverage (60%). Previous history of abortion/MR (50%), history of pelvic infection (30%) and history of D&C (16%) constitute the main bulk of risk factors. Most of the patients managed by laparotomy followed by salpingectomy which is still the standard treatment in many cases. Conclusions: Study has found that previous abortions are major etiological factor for ectopic pregnancy than previous pelvic infection. Most of the patients were managed by laparotomy. The general public should be made aware the sign and symptoms of ectopic pregnancy. Proper and modern diagnostic tools and training program for these should be made available in all tertiary level hospital