Study of risk factors associated with ectopic pregnancy: an observational study


  • V. Uthpala Department of Obstetrics and Gynecology, ACS Medical College and Hospital, Tamil Nadu, India
  • J. Leila Gracelyn Department of Obstetrics and Gynecology, ACS Medical College and Hospital, Tamil Nadu, India



Ectopic pregnancy, Pelvic inflammatory disease, Risk factors, Maternal mortality, Pregnancy


Background: Any pregnancy in which the fertilised ovum implants outside the intrauterine cavity is an ectopic pregnancy. Since none of the extrauterine areas can support placental attachment or a developing embryo, it invariably risks rupture and haemorrhage. It is thus considered a life-threatening emergency. Lower abdominal pain with vaginal bleeding in women of reproductive age raises the suspicion of an ectopic pregnancy. However, this is not always the case; some may present vague symptoms, oblivious to the underlying pathology. Hence this study aimed to document the potential risk factors for ectopic pregnancy.

Methods: This prospective study was carried out at a tertiary care hospital and included 60 women diagnosed with ectopic pregnancy. Detailed history, menstrual and obstetric history, clinical examination, urine pregnancy test, and ultrasonography were obtained for each patient. Their clinical profile was noted, including their name, age, marital status, socioeconomic status, parity, and last childbirth. A list of potential risk factors was compiled. The general, systemic, abdominal and vaginal examination was done. Data were collected and evaluated.

Results: 60 cases of ectopic pregnancies were diagnosed during the study period. The highest number of patients were noted in the 20-24 years age group (n=21) and the least in the 35–39 years age group (n=1). Pain in the abdomen was the most commonly noted symptom at 88.3%, followed by bleeding per vaginum (76.7%), vomiting (73.3%), fainting (58.3%), shock (30.0%), and abdominal distention (21.7%). While 18.3% of cohorts did not present with any risk factor, pelvic inflammatory disease (n=13) was the most commonly noted risk factor.

Conclusions: Ectopic pregnancy is a life-threatening medical emergency which requires a keen eye for detail. A comprehensive narrative of clinical history, signs and symptoms aided by appropriate diagnostic tools will help side-step fatalities.



Harish KM, Shwetha N, Nalini N. Incidence and risk factors associated with ectopic pregnancy: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2021;10(2):703-6.

Li C, Zhao WH, Zhu Q, Cao SJ, Ping H, Xi X, Qin GJ, Yan MX, Zhang D, Qiu J, Zhang J. Risk factors for ectopic pregnancy: a multi-center case-control study. BMC Pregnancy Childbirth. 2015;15:187.

Chaudhari SC, Chaudhari SC. A study factors associated with ectopic pregnancy at tertiary health care center. MedPulse – Int J Gynaecol. 2017;4(1):4-6.

Andola S, Kumar RR, Desai RM, Krutika SA. Study of Risk factors and treatment modalities of ectopic pregnancy. J Family Med Prim Care. 2021;10:724-9.

Abdulkareem TA, Eidan SM. Ectopic Pregnancy: Diagnosis, Prevention and Management. Obstetrics. IntechOpen. 2017.

Ranji GG, Usha Rani G, Varshini S. Ectopic Pregnancy: Risk Factors, Clinical Presentation and Management. J Obstet Gynaecol India. 2018;68(6):487-92.

Assouni Mindjah YA, Essiben F, Foumane P, Dohbit JS, Mboudou ET. Risk factors for ectopic pregnancy in a population of Cameroonian women: A case-control study. PLoS One. 2018;13(12):e0207699.

Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancy. J Fam Plann Reprod Health Care. 2011;37(4):231-40.

Prasanna B, Jhansi CB, Swathi K, Shaik MV. A study on risk factors and clinical presentation of ectopic pregnancy in women attending a tertiary care centre. IAIM. 2016;3(1):90-6.

Gupta R, Porwal S, Swarnkar M, Sharma N, Maheshwari P. Incidence, trends and risk factors for Ectopic Pregnancies in a tertiary care hospital of Rajasthan. J Pharm Biomed Sci. 2012;16(07):1-3.

Nath J, Mishra A, Verma V, Gupta S. A 5-year Study on Ectopic Pregnancy in North India. Sch Int J Obstet Gynec. 2021;4(3):49-54.

Bouyer J, Coste J, Shojaei T. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003;157(3):185-94.

Ranji GG, Rani GU, Varshini S. Risk factors and clinical features of ectopic pregnancy. Rev Med Inst Mex Seguro Soc. 2017;55(3):278-85.

Panchal D, Vaishnav G, Solanki K. Study of Management in Patient with Ectopic Pregnancy. Nat J Integrated Res Med. 2011;2(3):91-4.

Shetty S, Shetty A. A clinical Study of Ectopic Pregnancies in a Tertiary care hospital of Mangalore, India. Innovative J Med Health Sci. 2014;4(1):305-9.

Bhavna, Gupta K.B, Pathania K, Jindal M, Vohra R, Ahmed M. Risk Factors For Ectopic Pregnancy: A Case Control Study In Tertiary Care Centre. J Dent Med Sci. 2014;13(3):23-7.

Wang X, Huang L, Yu Y, Xu S, Lai Y, Zeng W. Risk factors and clinical characteristics of recurrent ectopic pregnancy: A case-control study. J Obstet Gynaecol Res. 2020;46(7):1098-103.

Anorlu RI, Oluwole A, Abudu OO, Adebajo S. Risk factors for ectopic pregnancy in Lagos, Nigeria. Acta Obstet Gynecol Scand. 2005;84(2):184-8.

Ranchal S, Dunne C. Diagnosis and treatment of ectopic pregnancy. BMCJ. 2021;63(3):112-6.






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