Verma Manju Lata, Singh Uma, Solanki Vandana, Sachan Rekha, Sankhwar Pushp Lata
Department of Obstetrics and Gynaecology, KGMU, Lucknow, Uttar Pradesh, India.
Gynecol Minim Invasive Ther. 2022 Feb 14;11(1):36-40. doi: 10.4103/GMIT.GMIT_1_21. eCollection 2022 Jan-Mar.
Diagnosis of ectopic pregnancy (EP) needs high index of clinical suspicion. If EP is timely diagnosed and timely intervened, i.e., before rupture, it may cause reduction of serious morbidity and mortality. We aimed to analyze the profile of patients of ectopic pregnancies and their outcome.
The sample for this retrospective cross-sectional study was derived from the database from January 2017 to December 2020. Data from outdoor patient registers, case record files, discharge summaries and hospital admission/discharge registers were screened. Parameters age, parity, risk factors, clinical presentation, per-operative findings, and maternal outcome in terms of morbidity and mortality were assessed.
Totally 27,525 deliveries occurred during the study period of 3 years, of which 640 were ectopic pregnancies, i.e., 2.3%. Out of 640, 415 (64.8%) were acute ruptured ectopic pregnancies, 62 (9.6%) were chronic ruptured pregnancies, and 163 (25.4%) patients were unruptured ectopic pregnancies. The mean age was 28.67 years (range: 29.5-27.8). The most common site of rupture was ampullary (54%, 225/415). 14.8% (95/640) of cases were in hemorrhagic shock out of total ectopic patients, and in ruptured group, they comprised 22.8% (95/415). Success for medical management with single-dose methotrexate in our study was 90.2% (147/163).
Pelvic inflammatory disease and history of induced abortion were found to be the most important etiological factor in ectopic pregnancies. Comprehensive clinical examination is 100% sensitive in diagnosis of EP. In ultrasound, the presence of adnexal mass is the most common finding which is additive to clinical findings and not substitute. Although multiple management options are available, best outcome is attained if management of EP is done at earliest without any delay.
异位妊娠（EP）的诊断需要高度的临床怀疑指数。如果能及时诊断并及时干预，即在破裂前进行干预，则可能降低严重并发症的发生率和死亡率。我们旨在分析异位妊娠患者的特征及其结局。
本回顾性横断面研究的样本取自2017年1月至2020年12月的数据库。筛选门诊患者登记册、病历档案、出院小结和医院出入院登记册中的数据。评估年龄、产次、危险因素、临床表现、术中发现以及孕产妇在发病率和死亡率方面的结局等参数。
在3年的研究期间共发生27525例分娩，其中640例为异位妊娠，占2.3%。在640例中，415例（64.8%）为急性破裂型异位妊娠，62例（9.6%）为慢性破裂型妊娠，163例（25.4%）患者为未破裂型异位妊娠。平均年龄为28.67岁（范围：29.5 - 27.8）。最常见的破裂部位是壶腹部（54%，225/415）。在所有异位妊娠患者中，14.8%（95/640）的病例处于失血性休克状态，在破裂组中，这一比例为22.8%（95/415）。在我们的研究中，单剂量甲氨蝶呤药物治疗的成功率为90.2%（147/163）。
盆腔炎和人工流产史被发现是异位妊娠最重要的病因。全面的临床检查对EP的诊断敏感性为100%。在超声检查中，附件包块的存在是最常见的发现，它可辅助临床发现，但不能替代。尽管有多种治疗选择，但如果能尽早且无延迟地对EP进行治疗，可获得最佳结局。
