Ectopic pregnancy; an analysis of 70 cases.

Sixty-two cases of ectopic pregnancy admitted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi from July, 1989 to December, 1990 were analysed to determine the incidence, risk factors, diagnostic features and management. During this period a total number of 10,798 patients were delivered giving an incidence of 1:174 births or 5.7 per 1000 births. In 48.3% cases the cause was unknown, 16.1% followed by pelvic inflammatory disease, 16.1% had history of D & E for abortion, 6.4% had history of different type of pelvic surgery, 4.8% had IUCD in situ, 1.6% had recurrent ectopic pregnancy. Diagnosis was made clinically in 80.6% cases. Culdocentesis was performed in all cases except one and was diagnostic in 90.1% cases. Ultrasound was performed in 51 cases and showed positive results in 90.1% cases. Laparoscopy was performed in only 10 cases and had 100% accurate results. After thorough re-suscitation laparotomy was performed in all cases. Partial salpingectomy was done in 53.2%, salpingectomy and tubal ligation in 32.2%. (They had already completed their family) and salpingo-oophorectomy in 4.8% cases. Tubes were conserved in 6.2% cases (all of them were primigravidas). In single abdominal pregnancy, dead fetus and placenta was removed from the peritoneal cavity very carefully. The mortality rate in this study was 1.6%.