Ectopic Pregnancy and Genital Tuberculosis: An Insight into The Determinants of Ectopic Pregnancy Among Patients Admitted in Obstetrics & Gynecology Department of Dhaka Medical College and Hospital, Bangladesh

Abstract

Abstract Bangladesh demonstrates a higher susceptibility to maternal mortality, particularly concerning the incidence of adverse events that occur during pregnancy. Ectopic pregnancy is also a pregnancy-related condition which accounts for 10% of pregnancy-related deaths during the first trimester. Therefore, in our study, we investigated the factors including genital TB associated with ectopic pregnancy in Bangladesh. All eligible women who are admitted to the indoor department of Obstetrics and Gynecology with diagnosed cases of rupture ectopic pregnancy and who give written informed consent are enrolled consecutively. Data are collected using a pre-tested semi-structured questionnaire, face-to-face interview, clinical examination, and recording of the investigation reports. We collected a total of 226 samples using a purposive sampling procedure from Dhaka Medical College, Bangladesh. Frequency table, factor analysis and clustering methods are used to describe the characteristics that are common to ectopic pregnant patients. Only 3.54% of women had a previous history of ectopic pregnancy and nearly 5% of women tested positive for TB when using Endometrial sampling for TBPCR. Over half of the women are from lower-income families (61.06%) with secondary schooling (69.03%). Around 7.08% and 11.5% of patients were previously affected by TB and contact with TB patients, respectively. 19.47% of women had a previous history of MR, among them 16.74% had spontaneous abortions, 11.06% used the D &C method, and 9.73% utilized induced abortion methods. The mean of white blood cell count, lymphocyte size, and Erythrocyte Sedimentation Rate is 10637.17, 17%, and 25.20, respectively. Age of respondents, occupation, Education, Contraceptive history, Previous history of MR, induced abortion, duration of marital life, type of delivery system, age of last child, and menstrual hygiene showed significant association with clusters of ectopic pregnant patients. The healthcare providers’ ability to both diagnose and counsel patients at risk for recurrent ectopic pregnancy can be optimized by awareness of the clinical features of this condition It is important to motivate women to seek care from a formal government or private institution and not from home, and women should seek care from a professional provider, and practice modern family planning to reduce the risk of ectopic pregnancy. The findings from this study can contribute to government collaboration to lead and scaling up the research for the greater impact on reproductive health and can give insight to policymakers to focus on reducing ectopic pregnancy as well as maternal mortality.