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Management of ectopic pregnancy in a peripheral hospital by a scoring system

Background: Even today, management of ectopic pregnancies in a peripheral hospital is a challenge and only timely intervention saves lives. Varying presentations and absence of diagnostic facilities in a peripheral hospital made the treating doctor to rely more upon clinical features. An objective scoring system can guide the primary contact general physician to be ectopic minded. Methods: A prospective observational study was carried out in a peripheral hospital to identify high risk clinical factors like pain abdomen, amenorrhea, bleeding per vaginum and certain clinical signs in reproductive age patients. Results: 17 patients were found to have ectopic pregnancies out of 19 suspected cases. All cases were managed by laparotomy and 14 ruptured cases were found amongst 17 cases. Demographic profile of ectopic pregnancy in a peripheral set-up could be highlighted in the study. Conclusion: Ectopic pregnancy is an emergency and referrals from a peripheral set-up might cause dangerous delay in treatment. Varying presentation of ectopic pregnancy and lack of modern facilities in a peripheral set-up create a difficult situation in diagnosis of ectopic pregnancy. Also lack of skill and laparoscopic set-up in a peripheral hospital leave only laparotomy as the treating option.