EC Gynaecology

Introduction: The incidence of ectopic pregnancy has increased over the past few years and it still represents one of the main causes of maternal death in the first trimester. It is therefore important to address the issue of early diagnosis and management of this pathology.

Objectives: This work aims to study the means of diagnosis of ectopic pregnancies and the different therapeutic options.

Methods: It is a retrospective study of 50 cases of ectopic pregnancy treated in the CMNT emergency department, over a six-month period from November 01^st, 2016 to April 30^th, 2017. We consider all the EP in the study.

Results: Among participants, 54% of patients presented at least one risk factor.

The main symptoms that led patients to seek medical attention were pelvic pain in 90% of cases, metrorrhagia in 62% of cases, and amenorrhea in 76% of cases.

Once the diagnosis was suspected, its confirmation relied on βHCG levels and ultrasound confrontation.

The median β-HCG level at the time of the diagnosis of the EP was 2378 mIU/ml. Ultrasound examination showed indirect signs in most cases, such as a thickened endometrium in 10 cases (20%), or a significant peritoneal effusion in 76.31% of cases. An extrauterine gestational sac containing an embryo was found in 4 patients (8%), including 2 cases with positive cardiac activity.

Clinical, biological and ultrasound data helped guide the therapeutic choices of these patients: 84% have undergone surgical treatment and 16% of them had a medical treatment.

Conclusion: The improvement of diagnostic strategies for ectopic pregnancy have led to early detection of this pathology and allowed more conservative medical treatments to be employed. However, ultrasound imaging still has its limitations, and is one of the most operator-dependent imaging.

Keywords: Ectopic Pregnancy (EP); Maternal Death; First Trimester

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