Epidemiological Study of Ectopic Pregnancy in Lampang Hospital

Abstract

Objective: To explore the epidemiological and clinical findings of ectopic pregnancy in Lampang Hospital
Material and method: A cross-sectional descriptive study was conducted on 115 ectopic pregnant women who underwent surgery in Lampang Hospital between 1st March 2004 and 30th April 2007. Medical records were retrospectively reviewed for gynecological history, contraception, occupation, physical examination, investigation and intra-peritoneal blood loss.
The data was analyzed by descriptive statistics. Correlation between abdominal signs and tubal rupture was analyzed by Fisher’s exact test.
Results: The incidence was 9.3 per 1,000 life-birth. Mean age of the patients was 28.7 years (range, 16-43). Most of them were employee, two-third had no contraception and one-third was second pregnancy. Vaginal bleeding was found in 57.4% of cases at average of 9.7 days, among these, 10.4% underwent uterine curettage. One-fourth had hypovolemic shock. Urine beta-HCG and ultrasonography were positive in 98.9% and 98.7% respectively. Nineteen percent of the patients had delayed diagnosis in non-gynecologic wards. Laparotomy was performed in most of cases, 97.4% was found at fallopian tube and 48.7% was ruptured.
Abdominal tenderness and guarding was found in 92% and 36% of cases respectively. Tubal rupture was significantly correlated with guarding (p=0.001), but not correlated with tenderness (p=0.49).
Conclusion: The incidence of ectopic pregnantcy in Lampang Hospital was comparable with other series. One fifth had delayed diagnosis. Abdominal guarding was significantly correlated with tubal rupture.