Types and Efficacy of Diagnostic Modalities of Ectopic Pregnancy

BACKGROUND Ectopic pregnancy is not only the gynaecologist’s most critical emergency but also one of the major problems because of its difficulties in diagnosis, increased risks of mortality, and its profound implications with regard to future reproductive performance. We wanted to study the types and accuracy of various diagnostic modalities, and effect of various management modalities of ectopic pregnancy. METHODS This study was conducted at Meenakshi Medical College Hospital and Research Institute, Kanchipuram, for a period of 32 months from May 2010 to October 2012. During the same period, there were 2602 reported pregnancies. RESULTS The incidence of ectopic pregnancy in the study is 15.3 / 1000 reported pregnancies. The incidence of ectopic pregnancy in patients with prior abdominal surgery was 86.6 %. Only 77.5 % patients gave history of typical amenorrhea. 22.5 % patients gave history suggestive of atypical amenorrhoea. It was noted that 55 % cases presented as tubal rupture, 7.5 % as tubal abortion, 35 % cases presented with intact tubal pregnancy and 2.5 % cases presented as ovarian pregnancy. The choice of management in our study included ipsilateral partial salpingectomy in 27.5 %, ipsilateral total salpingectomy in 45 %, ipsilateral salpingectomy with contralateral salpingo-oophorectomy in 5 % and bilateral salpingectomy in 22.5 % of cases. CONCLUSIONS Combination of accurate history, meticulous physical examination, ’Pregcolor’ urinary assay, culdocentesis and ultra-sonography will lead to early diagnosis. Transvaginal sonography is the best method of diagnosis in cases of ectopic pregnancy presenting in earlier weeks of gestation.\ KEYWORDS Culdocentesis, Ultra Sonography, Transvaginal Sonography, Ectopic Pregnancy