Clinical Study of Ectopic Pregnancy in Nepal

Introduction: Ectopic pregnancy is a global problem yet many women are unaware of this condition. In a low- income country like Nepal, women don’t seek timely antenatal care so early diagnosis of ectopic pregnancy becomes a challenge in our setting. Ectopic pregnancy if left untreated can result in maternal morbidity and mortality. Objective: The study was carried out to find out the incidence of ectopic pregnancy as well as to elucidate risk factors in such women which will help in identifying the high risk groups and making them aware about the condition. Methods: This hospital based observational study was carried out retrospectively between May 1, 2019 to April 30, 2020 in Gandaki Medical College. All confirmed 33 cases of ectopic pregnancy were included in the study. The total number of deliveries during this period was obtained from the labor ward registers. Data were analyzed usingdescriptive statistics. Results: In the present study, the incidence of ectopic pregnancy was 1.5%. Most ectopic pregnancies were in the age group 21-25 years and 31-35 years with 81.8% women being multiparous. 36.36% of ectopic pregnancies had gestational age of more than 8 weeks. Use of emergency pills and medical abortion were the most common identifiable risk factors. In 15.15% of patients, no cause was identified. The most common symptom was abdominal pain which was present in 100% of patients followed by amenorrhea(72.7%) and vaginal bleeding (45.4%). 97% of ectopic pregnancies were located in fallopian tube, ampulla being more common. Tubal rupture and hemoperitoneum were present in 75.75% of patients which were managed successfully by radical surgery. Conclusion: The incidence of ectopic pregnancy is on the rise due to various contributing factors. Timely detection and intervention can help to prevent maternal catastrophe. Hence knowledge regarding risk factors is necessary when we are counselling women about ectopic pregnancy. Keywords: Ectopic, Incidence, Maternal Mortality, Risk Factors, Symptoms