Incidence, Predictability and Causes of Tubal Rupture IN Ectopic Pregnancy in a Pakistani Population: A Descriptive Cross-Sectional Study
Author(s): Meena Bai, Ome Kulsoom*, Azra, Bushra, Jabeen Atta and Shumaila Javaid
Abstract
Background: Despite the advances in medical and healthcare sector, ectopic pregnancy remains a prime cause of maternal disability, death, fetal demise and devastating fate of pregnant women especially in the developing world. The usual extra uterine location of ectopic implantation is the fallopian tube, causing 96 percent of all ectopic gestations. The objective of this study is to determine the incidence, predictability and causes of tubal rupture in ectopic pregnancy in patients residing in Pakistan. Material and Methods: A descriptive cross sectional study involving patients of tubal rupture in ectopic pregnancy among all indoor patients visiting Gynaecology and Obstetrics department of Civil Hospital Dow University of Health Sciences Karachi Pakistan from 1 Jan 2020 to 31 Dec 2020. Data was collected pertaining to patients’ age, parity, gestational age, past medical history and duration of symptoms. Microsoft Excel and SPSS 22 were used for data analysis. Results: 73 diagnosed cases of ectopic pregnancy among 6346 pregnant patients reported in the year 2019. The incidence of tubal rupture was 87.67% (64/73). Tubal rupture was more prevalent in patients of age ≤ 24 years and with low parity. In this age group with null parity, the incidence of ruptured ectopic pregnancy was up to 100%. The incidence of tubal rupture was found to be inversely proportional to maternal age and parity, decreasing to 75% with parity of four. In addition, it was found that increase in gestational age from 7 weeks to 11 weeks increased the incidence of tubal rupture from 84.48% to 100% respectively. Seeking earlier medical care was associated with lesser events of tubal rupture in comparison with late report to a hospital after 4 days which elevates the incidence to 100%. Conclusion: The significantly higher incidence of tubal rupture in ectopic pregnancy in Pakistan is a major cause of maternal mortality, morbidity and reduced childbearing potential among women of reproductive age. Prompt identification of high risk groups with predictable signs and precise assessment of variable presentation can prove crucial in decreasing maternal mortality. Mass awareness in women of reproductive age to seek early medical care and precise management in high risk groups is the need of the hour.