A Prospective study on Medical Management of Ectopic Pregnancy

BACKGROUND: An ectopic pregnancy occurs when a fertilized ovum implants outside the normal uterine cavity and accounts for 0.5to 1.5 percent of all first -trimester pregnancy It is the most important cause of maternal mortality and morbidity in the first trimester. In this study, it will be discussed about medical management of ectopic pregnancy mainly by methotrexate. AIM AND OBJECTIVES: • To study about the clinical presentation and the risk factors associated with ectopic pregnancy. • Efficacy of methotrexate treatment for ectopic pregnancies in our settings which will in turn help to reduce maternal mortality and morbidity. MATERIALS AND METHODS: This is prospective study. This study was conducted at the department of Obstetrics and Gynaecology, GOVT. RAJA MIRASUDAR HOSPITAL, THANJAVUR MEDICAL COLLEGE HOSPITAL, Thanjavur. 34 cases were studied during a 1½ years study period between January 2019 and JUNE 2020 at RMH, Thanjavur. RESULTS: Total number of ECTOPIC PREGNANCIES reported was 160 cases for 27110 deliveries, the incidence of ectopic pregnancy is 0.60%. About 160 cases, 126 CASES were Presented as RUPTURED tubal ectopic was 126 cases, UNRUPTURED 34 Cases. The maximum incidence of ectopic pregnancy occurred between 26 to 30 years. Greater incidence was noted in second gravida ladies accounting for 41.2% that is 14 out of 34 cases. Common risk factors are previous H/O ectopic medically managed8.7%, History of infertility11.6%, tubectomy in 2 patients (5.8%), tuboplasty done at 1 case, PID (8.8%), tuberculosis (5.8%), Pre-H/O ectopic medically managed with D&C done (2.9%) IUCD (2.9%), OC PILLS (2.9%) H/O appendicectomy (2.9%), No risk factors were seen in 35.29%. The typical triad of amenorrhea, pain abdomen and bleeding were observed in 4 cases. atypical presentation was seen in 4 patients (11.8%) Ultrasonography diagnosed ectopic as adnexal mass in 28 patients and presents as tubal ectopic in 8 cases. Among that, ampulla is the commonest site. Right sided ectopic gestation was commonly seen compare ...