Mehreen Mehdi Naqvi, Azra Naseem, Humaira Nasir.
Risk factors and clinical features of ectopic pregnancy.
J Rawal Med Coll Jan ;17(1):116-8.

Background: To determine the clinical features and risk factors in ectopic pregnancy. Methods: In this descriptive study forty two patients who were diagnosed with ectopic pregnancy were included. Information regarding frequency of ectopic pregnancy, age, parity, signs and symptoms, treatment and associated maternal mortality and morbidity were studied. Diagnosis was made on the basis of signs, symptoms, ultrasound (TVS/abdominal) and βhcG levels. Laparotomy was decided on the basis of clinical features investigations. Results: Abdominal pain was seen in 83.33%, whereas history of amenorrhea was present in 76.19%. Twenty five (59.52%) patients presented with vaginal bleeding while 66.66% patients had pallor and 19.04% were in shock at the time of admission. Urinary BhcG was positive in 76.19%,while ultrasound revealed ectopic pregnancy in 71.42%. Adenexal mass was detected in 33.09%. Bulge in the fornices was felt in 23.80% while cervical excitation was present in 52.38%. Majority (69.04%) of the patients with ectopic pregnancies were multigravidas. Gestational age varied from 5 weeks to 11 weeks. Risk factors were present in majority(80.95%) of the patients. Eight patients (19.04%) were infertile, 4(9.52%) were tuberculous. Previous history of ectopic was present in 9.52%, while 14.28% patients had history of pelvic inflammatory disease. Two (4.76) patients had history of IUCD. Contraceptive use in the form of injection and pills was seen in two (4.76%) patients and 3 patients (7.14%) respectively. Forty (95.26) patients required emergency laparotomy while in 4(9.52%) patients conservative treatment was given. Conclusion:-Ectopic Pregnancy remains not only a diagnostic challenge but also a therapeutic emergency.

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