A study illustrating the risk factors, clinical presentation and management of ectopic pregnancy in a secondary hospital in Bahrain

Ola Shaltout; Fatema Waheed Akbar Mohammed Akbar Nawab Deen; Nawal Usman Mustafa; Marawan Mohamad ElSayed Mohamed Desouky; Alka Gupta; Rafiea Jeddy

doi:10.18203/2320-1770.ijrcog20223468

Authors

Ola Shaltout Royal College of Surgeons in Ireland, Bahrain http://orcid.org/0000-0002-7431-1405
Fatema Waheed Akbar Mohammed Akbar Nawab Deen Royal College of Surgeons in Ireland, Bahrain
Nawal Usman Mustafa Royal College of Surgeons in Ireland, Bahrain
Marawan Mohamad ElSayed Mohamed Desouky Royal College of Surgeons in Ireland, Bahrain
Alka Gupta Department of Obstetrics and Gynecology, American Mission Hospital, Bahrain
Rafiea Jeddy Royal College of Surgeons in Ireland, Bahrain American Mission Hospital, Bahrain

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20223468

Keywords:

Amenorrhea, B-hCG, Ectopic pregnancy, Methotrexate, Risk factors

Abstract

Background: Assess the risk factors, clinical presentation and type of intervention indicated in ectopic pregnancies at American mission hospital in Bahrain.

Methods: This is a retrospective cohort study conducted from August 2021 to April 2022 at American mission hospital in Bahrain. All patients (n=205) who attended the hospital from January 2017 to June 2021 with a presentation suggestive of ectopic pregnancy were extracted from the electronic medical record database and reviewed. Data was recorded on Microsoft Excel version 16.61.1 and numerical data was extrapolated into graphs and tables via IBM SPSS Statistics version 28.0.0.0 (190). Data was subjected to descriptive and stratification analysis.

Results: The leading risk factor for ectopic pregnancy was previous pelvic surgery (40.4%). The most reported symptom was amenorrhea (65.9%). Risk of rupture was tripled when serum B-hCG level was elevated, rendering it the strongest predictor of rupture according to our data (95% CI=1.25, 7.19; p-value 0.0139). Majority of patients (56.4%) were treated with methotrexate with a success rate of 88.7% and 8.5% of cases were managed expectantly. Those who failed medical management or presented with rupture were treated surgically.

Conclusions: Our study found B-hCG levels to be the most sensitive predictor of rupture and need for surgical intervention. Therefore, management was largely, but not exclusively, based on B-hCG levels. Majority of cases were treated medically and patients undergoing expectant management experienced no complications.

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