Clinical analysis of ectopic pregnancies in a tertiary care center: a two-year retrospective study


  • Bhavesh B. Airao Department of Obstetrics and Gynaecology, C.U. Shah Medical College, Surendranagar, Gujarat, India
  • Jahnvi M. Vyas Department of Obstetrics and Gynaecology, C.U. Shah Medical College, Surendranagar, Gujarat, India



Amenorrhea, Ectopic pregnancy, Risk factors, B-Hcg, Salpingectomy


Background: Ectopic pregnancy is defined as the implantation and development of blastocyst at a site other than the endometrial lining of the uterine cavity. With its incidence rising, there have been advances in its early diagnosis by Transvaginal sonography, B-Hcg assays and availability of medical and surgical management, thereby reducing mortality and morbidities.

Methods: 100 cases were reported in a span of 2 years. Incidence, causes, diagnosis, past history of infertility treatment, tubal ligation, B-Hcg level, hemoglobin level, USG findings were reviewed and the cases were managed accordingly.

Results: Incidence was 1/170 pregnancies and was highest between 25-30 years of age; more common in multigravida than primigravida; lower abdominal pain being the most common presenting complain followed by bleeding per vaginum. Etiology-idiopathic>previous abortion>pelvic infection>infertility treatment>previous ectopic>previous pelvic surgeries. Tubal ectopic being the most common followed by cornual>ovarian>rudimentary horn>scar ectopic>abdominal ectopic. More than 2/3rd cases were ruptured ectopics yet most patients were vitally stable at the time of presentation and immediate laprotomy followed by salpingectomy was the preferred modality. Patients who were hemodynamically stable, had Gsac size <4 cm by TVS, B-hcg levels <10,000 U/ml and no free fluid in the pelvic cavity, were managed medically. Most patients required blood transfusion, other than that there was trivial morbidity and no mortality.

Conclusions: Most patients being vitally stable on presentation so timely diagnosis and management could prevent mortality and reduce the morbidities to a great extent.

Author Biography

Jahnvi M. Vyas, Department of Obstetrics and Gynaecology, C.U. Shah Medical College, Surendranagar, Gujarat, India




Singh S, Mahendra G, Vijayalakshmi S, Pukale RS. Clinical study of ectopic pregnancy in a rural setup: A two year survey. Natl J Med Res. 2014;4(1):37–9.

Khaleeque F, Siddiqui RI, Jafarey SN. Ectopic pregnancies: A three year study. J-Pak Med Assoc. 2001;51(7):240–2.

Udigwe GO, Umeononihu OS, Mbachu II. Ectopic pregnancy: a 5 year review of cases at nnamdiazikiwe university teaching hospital (NAUTH) Nnewi. Niger Med J. 2010;51(4):160.

Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Hum Reprod Update. 2014;20(2):250–61.

Panti A, Tanko B, Yakubu A, Egondu S, Ikechukwu N, Lukman O. Ectopic pregnancy at UsmanuDanfodiyo University Teaching Hospital Sokoto: A ten year review. Ann Niger Med. 2012;6(2):87.

Igwegbe A, Eleje G, Okpala B. An appraisal of the management of ectopic pregnancy in a nigerian tertiary hospital. Ann Med Health Sci Res. 2013;3(2):166–70.

Shah P, Shah S, Kutty RV, Modi D. Changing epidemiology of maternal mortality in rural India: time to reset strategies for MDG-5. Trop Med Int Health. 2014;19(5):568–75.

Yadav K, Namdeo A, Bhargava M. A retrospective and prospective study of maternal mortality in a rural tertiary care hospital of Central India. Indian J Community Health. 2013;25(1):16–21.

Shetty S, Shetty A. A clinical Study of Ectopic Pregnancies in a Tertiary care hospital of Mangalore, India. Innov J Med Health Sci. 2014;4(1):600.

Baria D, Thaker R, Patel M, Shah S, Shah P, Jani S. Analysis of ectopic pregnancy at a tertiary care hospital: one year study. Int J Reprod Contracept Obstet Gynecol. 2013;2(4):621.

Jabbar FA, Al-Wakeel M. A study of 45 cases of ectopic pregnancy. Int J GynaecolObstet Off Organ Int Fed Gynaecol Obstet. 1980;18(3):214–17.

Jani R, Munshi D, Jani S, Munshi S. Study of 50 cases of modern management of ectopic pregnancy. Int J Reprod Contracept Obstet Gynecol. 2014;3(2):374–79.

Pal A, Gupta KB, Sarin R. A study of ectopic pregnancy and high risk factors in Himachal Pradesh. J Indian Med Assoc. 1996;94(5):172–3.

Tancer ML, Delke I, Veridiano NP. A fifteen year experience with ectopic pregnancy. Surg Gynecol Obstet. 1981;152(2):179–82.

Saranovic M, Vasiljevic M, Prorocic M, Macut ND, Filipovic T. Ectopic pregnancy and laparoscopy. Clin Exp Obstet Gynecol. 2014;41(3):276–9.

Cornelius AC, Onyegbule A, Onyema null, Uchenna ET, Duke OA. A five year review of ectopic pregnancy at Federal Medical Centre, Owerri, South East, Nigeria. Niger J Med J Natl Assoc Resid Dr Niger. 2014;23(3):207–12.

Taheri M, Bharathan R, Subramaniam A, Kelly T. A United Kingdom national survey of trends in ectopic pregnancy management. J Obstet Gynaecol J Inst s Obstet Gynaecol. 2014;34(6):508–11.

van den Berg MMJ, Goddijn M, Ankum WM, van Woerden EE, van der Veen F, van Wely M, et al. Early pregnancy care over time: should we promote an early pregnancy assessment unit? Reprod Biomed Online. 2015;31(2):192–8.

Okmen F, Zeybek B, Akdemir A, Ergenoglu AM, Yeniel O, Ulukus M. Is there a relationship between age and side dominance of tubal ectopic pregnancies? A preliminary report. Ginekol Pol. 2014;85(9):677–81.

Ectopic pregnancy and miscarriage. NICE Quality standard [Internet]. National Institute for Health and Clinical Excellence; 2014. Available from: Accessed on 5 August 2022.

French S, Henry T, Williams E. Evaluation of Waiting Times and Sonographic Findings in Patients with First Trimester Vaginal Bleeding at the University Hospital of the West Indies. Can Emergency Department Ultrasound Make a Difference? West Indian Med J. 2014. Available from: fms/wimj/article/1854. Accessed on 5 August 2022.

Horne AW, Shaw JL, Murdoch A, McDonald SE, Williams AR, Jabbour HN, et al. Placental growth factor: a promising diagnostic biomarker for tubal ectopic pregnancy. J Clin Endocrinol Metab. 2011;96(1):E104–8.

Cabar FR, Pereira PP, Schultz R, Francisco RP, Zugaib M. Association between ultrasound findings and serum levels of vascular endothelial growth factor in ampullary pregnancy. Fertil Steril. 2015;103(3):734–37.

National Family Health Survey-4, 2016 [cited 2016 Apr 19].






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