Clinical Profile, Risk Factors and Outcomes of Ectopic Pregnancy in a Tertiary Care Hospital: A Prospective Indian Study

Abstract

Objectives To determine the clinical profile, management and outcomes in patients of ectopic pregnancy (EP) presenting to the hospital. Methods A prospective observational study was done on 75 women with ectopic pregnancy among a total of 1350 women who attended the Gynecology department over a period of 18 months from December 2020 until June 2022. The details of patients such as age, socioeconomic status, referral, symptoms, obstetric history, and signs and symptoms were recorded. Ultrasound was done and the site of ectopic pregnancy was determined. Management of patients was done according to hospital protocol; outcomes were recorded. Results The frequency of EP in the present study was 5.55%. The majority of the cases (60%) were between 20-30 years of age, from the lower middle class (57%), referral cases (63%), and multigravida (i.e. >G4) (31%) cases. Amenorrhea was the most common symptom seen in 73 (97.33%) cases. On ultrasound, the most common finding was tubo-ovarian mass (33.33%). In the majority of patients [28 (37.33%)], the ampullary region in the fallopian tube was the site of EP. History of pelvic inflammatory disease was most common risk factor [26 (19.5%)]. Surgical management was done in 74 cases and one case was managed medically. Salpingectomy alone was done in 47 (62.67%) cases. Rupture ectopic pregnancy was seen in 71 (95%) cases where all cases needed blood transfusion. One patient needed ventilatory support/ICU admission and had mortality. Conclusion We report a frequency of 5.55% for EP. The patients with EP were in the age groups of 20-40 years and belonged primarily to lower socioeconomic class. The most common symptom was amenorrhea. The most common site of ectopic pregnancy was the ampullary region. Rupture ectopic is a common worrisome complication. Early diagnosis of the site and surgical management is the key to better management of ruptured cases.