Risk Factors for Ectopic Pregnancy: A Case-Control Study in Tertiary Care Hospitals of Jammu and Kashmir
Factores de riesgo para el embarazo ectópico: un estudio de casos y controles en hospitales de atención terciaria de Jammu y Cachemira
Neha Mahajan, Rohit Raina, Pooja Sharma
Abstract
Introduction: An ectopic pregnancy occurs when a fertilized egg attaches somewhere outside the uterus.There are many risk factors for ectopic pregnancy. This study will help us to prepare a list of risk factors associated with ectopic pregnancy in our state. In addition, it will help implement a risk-reduction counseling program before conception, which will help us screen high-risk patients and reduce and manage ectopic pregnancy.
Materials and methods: The present study was conducted in our department for two years, from August 2018 to July 2019. Cases included all patients with ectopic pregnancy admitted in labor. A total of 192 cases were taken, out of which 8 cases refused to participate in the study, so 184 patients were included in the study.
Results: Patients with previous ectopic pregnancy have 6.34 times increased risk of a repeat ectopic pregnancy (odds ratio 6.34, confidence interval 1.40-28.77), and this association was highly significant (p = 0.006). The risk of ectopic pregnancy is 3.02 times increased (odds ratio 3.10; 95% confidence interval, 1.16-7.84) if the patient once had the pelvic inflammatory disease and is statistically significant (p = 0.01). The study also revealed that 17 (10.3%) patients with ectopic pregnancy had a history of tubal ligation or some other tubal surgery done in the past compared to 3 (2.2%) patients among controls, and this finding is statistically highly significant (p = 0.001).
Conclusions: In the present study, we found that the main risk factors for incidence of ectopic pregnancy are prior ectopic pregnancy, prior tubal ligation, and prior pelvic/abdominal surgery. In addition, ectopic pregnancy was positively related to the previous history of ectopic pregnancy, abortion, cesarean section, and infertility. These findings can be helpful for early diagnosis of ectopic pregnancy to pursue proper medical therapy instead of unnecessarily surgical treatment.
Keywords
Resumen
Introducción: Un embarazo ectópico ocurre cuando un óvulo fertilizado se adhiere en algún lugar fuera del útero. Existen muchos factores de riesgo para el embarazo ectópico. Este estudio nos ayudará a preparar una lista de factores de riesgo asociados con el embarazo ectópico en nuestro estado. Además, ayudará a implementar un programa de asesoramiento para la reducción de riesgos antes de la concepción, que nos ayudará a evaluar a las pacientes de alto riesgo y reducir y controlar el embarazo ectópico.
Materiales y métodos: El presente estudio se realizó en nuestro servicio durante dos años, de agosto de 2018 a julio de 2019. Los casos incluyeron a todas las pacientes con embarazo ectópico ingresadas en trabajo de parto. Se tomaron un total de 192 casos, de los cuales 8 casos se negaron a participar en el estudio, por lo que se incluyeron 184 pacientes en el estudio.
Resultados: Las pacientes con un embarazo ectópico previo tienen un riesgo 6,34 veces mayor de un embarazo ectópico repetido (razón de probabilidades 6,34, intervalo de confianza 1,40-28,77), y esta asociación fue muy significativa (p = 0,006). El riesgo de embarazo ectópico aumenta 3,02 veces (razón de posibilidades 3,10; intervalo de confianza del 95%, 1,16-7,84) si la paciente tuvo una vez la enfermedad inflamatoria pélvica y es estadísticamente significativa (p = 0,01). El estudio también reveló que 17 (10,3%) pacientes con embarazo ectópico tenían antecedentes de ligadura de trompas o alguna otra cirugía de trompas realizada en el pasado en comparación con 3 (2,2%) pacientes entre los controles, y este hallazgo es estadísticamente muy significativo (p = 0,001).
Conclusiones: En el presente estudio, encontramos que los principales factores de riesgo de incidencia de embarazo ectópico son embarazo ectópico previo, ligadura de trompas previa y cirugía pélvica/abdominal previa. Además, el embarazo ectópico se relacionó positivamente con la historia previa de embarazo ectópico, aborto, cesárea e infertilidad. Estos hallazgos pueden ser útiles para el diagnóstico temprano de embarazo ectópico para buscar una terapia médica adecuada en lugar de un tratamiento quirúrgico innecesario.
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References
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Submitted date:
05/20/2021
Reviewed date:
06/26/2021
Accepted date:
07/18/2021
Publication date:
08/04/2021
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