Audit of Management of Ectopic Pregnacy in Tertiary Care Hospital

Dr. Thete Mayuri Sharad, Dr. Suresh Rawte, Dr. Hrishikesh Mandhane

Abstract: Introduction: Ectopic pregnancy is a serious reproductive health condition where a fertilized ovum implants outside the uterine cavity, most commonly in the fallopian tube or, in rare cases, in a cesarean scar. It remains a significant cause of maternal morbidity. Early diagnosis using ultrasound and serum ?-hCG levels, along with advancements in laparoscopic management, has improved outcomes. However, risk factors such as previous cesarean sections, tubal surgeries, and pelvic infections continue to pose challenges, highlighting the importance of early detection and preventive strategies in clinical practice. Materials and method: Type of study: Retrospective study. Study area: MGM Medical College and Hospital, Chhatrapati Sambhajinagar. Study period: 01st May 2023 to 31st January 2025. Sample size: 80 cases. Inclusion Criteria: All confirmed cases of ectopic pregnancy, irrespective of the location, diagnosed during the study period. Patients who underwent either medical or surgical intervention. Exclusion criteria: All ectopic pregnancies were included. Results: In this study of 80 ectopic pregnancy cases, the majority of patients were aged between 25?30 years (42.5%), with 90% being multigravida or grand multigravida, indicating higher risk among women with previous pregnancies. Tubal ectopic pregnancy was the most common type, accounting for 87.5% of cases, followed by cesarean scar ectopic pregnancies (7.5%). Among patients with a history of pelvic surgery, previous cesarean section was the leading risk factor (69.23%). Clinically, adnexal mass (61.25%) and cervical motion tenderness (53.75%) were the most frequent findings, while only one patient (1.25%) presented with shock. Laparoscopy was the preferred treatment method (91.25%), with suction and evacuation after methotrexate used in selected scar ectopic cases. Complications were observed in 56 patients, with blood transfusion (58.9%) and ICU admission (37.5%) being the most common. Blood loss was less than 500 ml in the majority (58.75%), though 18.75% experienced blood loss greater than 1000 ml. Scar ectopic pregnancies were managed effectively with minimal complications, and none required ICU care. Conclusion: Ectopic pregnancy remains a significant cause of maternal morbidity, particularly among multiparous women with prior cesarean sections. Early diagnosis and minimally invasive management, especially laparoscopy, significantly improve outcomes. Scar ectopic pregnancies, though rare, can be safely managed when detected early. Prompt intervention is critical to prevent complications like severe hemorrhage and the need for ICU care.

Keywords: scar ectopic, ectopic pregnancy, methotrexate, blood loss, ICU stay

How to Cite?: Dr. Thete Mayuri Sharad, Dr. Suresh Rawte, Dr. Hrishikesh Mandhane, "Audit of Management of Ectopic Pregnacy in Tertiary Care Hospital", Volume 14 Issue 5, May 2025, International Journal of Science and Research (IJSR), Pages: 1152-1155, https://www.ijsr.net/getabstract.php?paperid=SR25517092120, DOI: https://dx.doi.org/10.21275/SR25517092120