Prevalence and risk factors for laparoscopic managed ectopic pregnancies at a tertiary referral hospital - a 10-year synopsis: a cross sectional study.

backgroundEctopic pregnancies (EP) are a common pregnancy associated complication. They are associated with significant morbidity, and rarely mortality, if not managed properly. EP have a myriad of predisposing factors that help identify patients at risk and facilitate early diagnosis and intervention. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the incidence, prevalence and risk factors of their occurrence.

methodsThis study was designed as a Retrospective Clinical Audit based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis of ectopic pregnancy that was surgically managed between the period of January 1st 2011 to December 31st 2020. Analysis of data was done against a pre-set checklist. Descriptive statistics for continuous variables was calculated and tabulated in graphs and tables. SPSS version 22 was used for analysis of data.

resultsA total of 347 patient files were recruited in the study. The hospital-based incidence rate of surgically managed ectopic pregnancies was 1.78 per 100 live births between 2011 and 2020 as calculated against hospital delivery statistics in the period. There was a significant rise in surgically managed EP in the hospital per year with 26.6 cases/year prior to 2016 and 42.8 cases/year after 2016. 71.8% (n = 249) of the patients were below the age of 35 years while 28.2% (n = 98) were above the age of 35 years. 70.5% of women with an EP did not have any identifiable risk factors. 7.8% had previous tubal surgery for an EP. 7.5% of the participants had previous pelvic inflammatory disease or a positive Chlamydia Trachomatis infection. 6.6% of women mentioned current IUD use while 0.9% had antecedent EC use. 3.9% were on follow up for infertility or reported EPL and 2.4% had multiple factors. Only 0.3% of patients reported smoking.

conclusionThe present study outlines the higher incidence of surgically managed ectopic pregnancies in our population. Furthermore, we explored predisposing factors to EP which mostly mimic the pattern and occurrence in other populations. This study forms the index study in a series that looks at the pattern of surgically managed EP with the last study outlining the cost effectiveness of surgical management.