Observational Study, Risk Factors, Clinical Demonstration and Management of Ectopic Pregnancy in a Rural Tertiary Care Centre

Abstract

Ectopic pregnancy is a serious hazard to a woman’s health and requires prompt attention and early aggressive intervention. These complications are not only fatal loss but also causes significant maternal morbidity and mortality. Minimal invasive surgery is considered to be safest effective surgical solution for tubal ruptured ectopic pregnancy to reduce intra operative blood loss, analgesic requirements and hospital stay. Clinical retrospective study   was conducted in the period of three years (January 2018 to December 2020) in the department of obstetrics and Gynaecology at PIMS Hospital Islamabad Pakistan. A total of 90 confirmed case of ruptured tubal ectopic pregnancies were divided into 2 groups, laparoscopy (n=68) and laparotomy (n=22). The main outcome measures the demographic features like age, gravida, parity, previous spontaneous loss, previous MTP, Hb at admission, period of gestation, total blood loss and haemoperitonium and postoperative parameters blood loss, blood requirement and duration of hospital stay. No significant differences observed in age, gravida, parity, previous history of spontaneous loss and previous MTP in both laparoscopy and laparotomy procedure. Common demographic features were age (30 to 32 years), gravida (2-3) and parity (1). Patients with heavy blood loss >1000ml and massive hemoperitoneum were also undergone for laparoscopic procedure. Hospital stay and PRBC blood transfusion were less in patient undergone laparoscopic surgery. Laparoscopy is considered to be advantageous over laparotomy in terms of shorter hospital stay and speedy recovery and even in massive haemoperitoneum