Clinical Presentation and Diagnosis of Ectopic Pregnancy-A Dilemma?

Autor: Kumud Bala Gupta, Monika Jindal, Bhavna, Satwant Kaur
Rok vydání: 2014
Předmět:
Zdroj: Annals of Health and Health Sciences. 1:46
ISSN: 2322-0422
2322-0414
DOI: 10.5958/j.2322-0422.1.1.009
Popis: Background: Present study was conducted with a background in mind to study various clinical presentations and diagnostic modalities for ectopic pregnancy to reduce ectopic pregnancy related morbidity and mortality. Objective: To study the clinical presentation and diagnosis of ectopic pregnancy. Material and Methods: This prospective study was conducted over a period of 1 year at the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital, Shimla, from March 2011 to February 2012. In this case-control study, all the diagnosed cases of ectopic pregnancy were taken as cases and controls were the age-matched women with normal intrauterine pregnancy of same gestation age. Total number of cases with ectopic pregnancy, who reported to our institute during the study period, was 110. Results: Overall incidence of ectopic pregnancy was 18.62 per 1000 deliveries in the present study, with mean age of 28.72 years. Maximum cases were multi-gravidae (80.90%). Most common symptoms were pain in the abdomen (90.90%), amenorrhoea (82.72%), bleeding per vaginum (75.45%), gastrointestinal symptoms (37.27%) and syncopal attacks (25.45%). Typical triad of ectopic pregnancy was present in 49.09% of the cases. Most common signs were cervical motion tenderness (67.27%), abdominal tenderness (70.90%) and pallor (56.36%). Shock was present in 10 cases. Signs and symptoms were more significantly present in cases when compared with controls. Urine pregnancy test was positive in 106 cases and negative in 4 cases. Ultrasonography diagnosed ectopic pregnancy in 101 cases. Conclusion: Ectopic pregnancy still remains a dreadful condition which has always challenged the clinical acumen of obstetricians and gynaecologists. Clinical findings associated with ectopic pregnancy have a wide spectrum, ranging from a completely asymptomatic status to hypovolemic shock. The classical pattern of period of amenorrhoea and abdominal pain may be lacking in most of the patients; however, a provisional diagnosis can be made in the light of clinical features along with the sonological findings. Delayed diagnosis may lead to disasters in the form of mortality or morbidity.
Databáze: OpenAIRE