Ectopic pregnancy- presentation and management at allama iqbal memorial teaching hospital sialkot

Aim: To analyze the outcome of management of ectopic pregnany as regards its different presentations. Study Design: Prospective study. Place & duration of study: Department of Gynaecology and Obstetrics, Allama Iqbal Memorial Teaching Hospital. affiliated to Khawaja Muhammad Safdar Medical College, Sialkot from August 2017 to October 2020. Methods: From August 2017 to October 2020.; all patients serially presenting in the department of gynaecology both in emergency and outpatients' department of Allama Iqbal Memorial hospital. The patients were categorized in three groups: Group I- Acute Ectopic Pregnancy, Group II- Subacute Ectopic Pregnancy and GroupIIIAsymptomatic. A prospective clinical practice study was carried. All patients with Ectopic Pregnancy during this period were included. History and physical examination, investigations done, ultrasonographic findings and intraoperative findings were recorded. Results: Group- I Acute Ectopic pregnancy made the most of workload and included 442(65.57%) patients. Group-II Subacute Ectopic Pregnancy had 162(24.03%) patients and Group- III Asymptomatic patients were 70(10.38%). The main presenting symptoms were pelvic pain in the acute group while Subacute Group –II presented with adnexal masses while the Asymptomatic group were diagnosed on antenatal check up with the help of ultrasonography. The Group -I was managed by surgical laparotomies or stable cases were managed by laparoscopic procedures. a few cases of subacute group that were not fulfilling criteria were operated and some of the Group-III Asymptomatic; salpingostomies open 112(24.66%), open salpingectomies 313(68.94%), laparoscopic salpingostomies 6(1.32%) and laparoscopic salpingectomies 11(2.42%), 9(1.98%) and 3(0.66%). respectively in Group I, II and III. Wound infection was encountered 23(5.06%). Conclusion: The ectopic pregnancy presents in a variety of situations and the treatment of acute ectopic pregnancy presents real challenge of mortality and while the treatment of suacute cases is associated with much morbidity and complications leading to patients' dissatisfaction. (author)