Genital tuberculosis in adolescent girls from low socioeconomic status with acute ectopic pregnancy presenting at a tertiary care hospital in urban Northern India: are we missing an opportunity to treat?

Introduction: Predominant etiology of ectopic gestation is tubal damage, notably salpingitis, which may be of tubercular etiology.

Aims And Objectives: To compare the incidence of genital tuberculosis (GTB) in two groups of adolescent patients: one undergoing surgery for acute ectopic pregnancy, the other undergoing suction evacuation for spontaneous miscarriage and to evaluate GTB as a risk factor for ectopic pregnancy in adolescent girls from low socioeconomic status presenting to a tertiary care hospital in Northern India.

Materials And Methods: Prospective case-control study with 17 adolescent subjects from low socioeconomic status with acute presentation of ectopic pregnancy (group 1, study) undergoing laparotomy with 20 adolescent subjects with spontaneous miscarriage (group 2, control) undergoing suction evacuation. Subjects were tested for presence of GTB by presence of tubercular granuloma and/or positive growth on BACTEC radiometric assay from sample obtained from endometrial aspirate and products of conception in groups 1 and 2, respectively.

Results: Incidence of GTB was 35.29% (6 out of 17) in the study group compared with 5% in the control group (1 out of 20) (P=0.03).

Conclusion: The sample size of this pilot study is too small to arrive at the definite conclusion whether GTB is risk factor for acute ectopic in this population of patients. Larger studies are needed to validate this hypothesis. However, in the presence of risk factors/suggestive intraoperative findings, testing for TB in this set of population presenting with ectopic pregnancy may be justified to prevent further morbidity by initiating anti-tubercular therapy in high prevalence areas.