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Ectopic pregnancy: an 18-year review of management and outcome
Abstract
Background: Technological advances have led to earlier diagnosis of ectopic pregnancy with a decline in morbidity and mortality in developed countries. The purpose of this study was to determine the pattern of presentation, management and outcome of ectopic pregnancy over an 18-year period.
Methods: A retrospective descriptive analysis of cases of ectopic pregnancy at a referral centre over the period 1981-1998 was undertaken.
Results: The incidence of ectopic pregnancy increased from 3.8 per 1000 births in 1981-1989 to 11.6 per 1000 births in 1990-1998. The average age at presentation was 27.1 years and 41.8% of patients were nulliparous. The commonest symptoms were lower abdominal pain (93.4%), amenorrhoea (89.3%) and vaginal bleeding (71.3%), while the commonest signs were pallor (92.6%), abdominal tenderness (75.4%) and tachycardia (64.8%). Presentation was characteristically late and there were no changes in the pattern of presentation, method of diagnosis and management throughout the period reviewed. Laparotomy and salpingectomy was done in 75% of cases and 91% required blood transfusion. Four women died from 1981 to 1989 while only one woman died from 1990- 1998.
Conclusion: Women with ectopic pregnancy continue to present late precluding early diagnosis and use of conservative modalities of management. Morbidity remains high but mortality has declined.
Highland Medical Research Journal Vol. 3(2) 2005: 98-107
Methods: A retrospective descriptive analysis of cases of ectopic pregnancy at a referral centre over the period 1981-1998 was undertaken.
Results: The incidence of ectopic pregnancy increased from 3.8 per 1000 births in 1981-1989 to 11.6 per 1000 births in 1990-1998. The average age at presentation was 27.1 years and 41.8% of patients were nulliparous. The commonest symptoms were lower abdominal pain (93.4%), amenorrhoea (89.3%) and vaginal bleeding (71.3%), while the commonest signs were pallor (92.6%), abdominal tenderness (75.4%) and tachycardia (64.8%). Presentation was characteristically late and there were no changes in the pattern of presentation, method of diagnosis and management throughout the period reviewed. Laparotomy and salpingectomy was done in 75% of cases and 91% required blood transfusion. Four women died from 1981 to 1989 while only one woman died from 1990- 1998.
Conclusion: Women with ectopic pregnancy continue to present late precluding early diagnosis and use of conservative modalities of management. Morbidity remains high but mortality has declined.
Highland Medical Research Journal Vol. 3(2) 2005: 98-107
