Aim: The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India in opd and ipd from April 2019 to February 2022 antinatal check-up. Total 120 cases were diagnosed with ectopic pregnancy. Results: The incidence of ectopic pregnancy (0.029%) or 2.9 per 1000 antinatal up to 20 weeks. The most common site of ectopic pregnancy was fallopian tube 102(89.17%). Ampulla was the commonest site 90 (75%) for ectopic implantation in the fallopian tube. Heterotopic pregnancy is rare where pregnancy is seen in the uterus and tube at the same time. In our study, there were 3 (2.5%) cases of heterotopic pregnancies. The most common risk factor was pelvic inflammatory disease 55(45.83%) followed by H/o previous abortion 25(20.83%) and H/o previous abdominopelvic surgery including tubal ligation, LSCS and appendicectomy 32(26.67%). In our study, 17(14.17 %) patients were using copper IUCD. 67.5% of the patients had bleeding or spotting per vaginum. Urine pregnancy test was positive in 113(94.17%) of patients. Culdocentesis was positive in 53(44.17%) of patients. Ultrasound was able to diagnose 99(82.5 %) of cases. USG findings suggestive of ectopic pregnancy were extra-uterine gestational sac 15(12.5%), haemoperitoneum 71(59.17%) and adnexal mass 91(75.83%). The incidence of ruptured ectopic pregnancy was 88%. 97.5% of the patients received one or more units of blood transfusion intra operatively and/or post operatively. All the patients with ectopic pregnancy were managed surgically. 95% patients underwent laparotomy and 5 % patients had laparoscopic treatment. 95% patients underwent unilateral or bilateral salpingectomy or salpingoophrectomy. Milking of tube was performed in 2.5% of patients. Concurrent dilatation and curettage were performed in the patients who had heterotopic pregnancy 3 (2.5%). There was no maternal mortality in the present study. Conclusion: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.

Aim: The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India in opd and ipd from April 2019 to February 2022 antinatal check-up. Total 120 cases were diagnosed with ectopic pregnancy. Results: The incidence of ectopic pregnancy (0.029%) or 2.9 per 1000 antinatal up to 20 weeks. The most common site of ectopic pregnancy was fallopian tube 102(89.17%). Ampulla was the commonest site 90 (75%) for ectopic implantation in the fallopian tube. Heterotopic pregnancy is rare where pregnancy is seen in the uterus and tube at the same time. In our study, there were 3 (2.5%) cases of heterotopic pregnancies. The most common risk factor was pelvic inflammatory disease 55(45.83%) followed by H/o previous abortion 25(20.83%) and H/o previous abdominopelvic surgery including tubal ligation, LSCS and appendicectomy 32(26.67%). In our study, 17(14.17 %) patients were using copper IUCD. 67.5% of the patients had bleeding or spotting per vaginum. Urine pregnancy test was positive in 113(94.17%) of patients. Culdocentesis was positive in 53(44.17%) of patients. Ultrasound was able to diagnose 99(82.5 %) of cases. USG findings suggestive of ectopic pregnancy were extra-uterine gestational sac 15(12.5%), haemoperitoneum 71(59.17%) and adnexal mass 91(75.83%). The incidence of ruptured ectopic pregnancy was 88%. 97.5% of the patients received one or more units of blood transfusion intra operatively and/or post operatively. All the patients with ectopic pregnancy were managed surgically. 95% patients underwent laparotomy and 5 % patients had laparoscopic treatment. 95% patients underwent unilateral or bilateral salpingectomy or salpingoophrectomy. Milking of tube was performed in 2.5% of patients. Concurrent dilatation and curettage were performed in the patients who had heterotopic pregnancy 3 (2.5%). There was no maternal mortality in the present study. Conclusion: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.