Diagnosis and management of cases of ectopic pregnancy in a tertiary care centre: our experience


  • Anushka S. Mehta Department of Obstetrics and Gynecology, Smt. NHL Municipal Medical College and SVPIMSR Hospital, Ahmedabad, Gujarat, India
  • Riya R. Patel Department of Obstetrics and Gynecology, Smt. NHL Municipal Medical College and SVPIMSR Hospital, Ahmedabad, Gujarat, India
  • Parav D. Shah Department of Obstetrics and Gynecology, Smt. NHL Municipal Medical College and SVPIMSR Hospital, Ahmedabad, Gujarat, India




Ectopic pregnancy, Laparotomy, Amenorrhea, Tubal sterilisation, Methotrexate


Background: Ectopic pregnancy is a leading cause of maternal morbidity and mortality. With our study, we aim to highlight the importance of risk factors and effect of clinical presentation on the management modalities of ectopic pregnancy and study changing trends of modern management from radical surgical methods to medical and laparoscopic management of ectopic pregnancies.

Methods: This prospective study was undertaken at a tertiary care hospital between May 2021 and May 2022.

Results: The most common age group of presentation was 26-30 years. The most common risk factor was history of previous abortion. Amenorrhoea and abdominal pain were the most commonly encountered symptoms in this study. Cervical motion tenderness was significantly associated with ruptured ectopic pregnancy. Conservative medical management with injection methotrexate (Mtx), which was successful in 50% cases. Success rate was 100% for laparoscopic management and 100% for laparotomy in this study. No maternal mortality was observed during the present study.

Conclusions: Our hospital being a tertiary centre, had to manage a number of cases as surgical emergencies by laparotomy and not conservatively, as they brought in either diagnosed cases of ruptured ectopic pregnancy, or failure of medical management. It is important that in the face of this diagnostic dilemma, all physicians should be should maintain a high level of suspicion and be sensitive to the fact that in the reproductive age group any woman presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be considered irrespective of the presence or absence of amenorrhea or tubal sterilisation.


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

Attri P, Gupta A, Vij A, Gupta B. A clinical study of the incidence, management and outcome of ectopic pregnancy. Int J Clin Obstet Gynaecol. 2020;4(3):219-.

Tahmina S, Daniel M, Solomon P. Clinical analysis of ectopic pregnancies in a tertiary care centre in southern india: a six-year retrospective study. J Clin Diagn Res. 2016;10(10):QC13-6.

Epee-Bekima M, Overton C. Diagnosis and treatment of ectopic pregnancy. Practit. 2013;257(1759):15-7.

Marret H, Fauconnier A, Dubernard G, Misme H, Lagarce L, Lesavre M, et al. Overview and guidelines of off-label use of methotrexate in ectopic pregnancy: report by CNGOF. Eur J Obstet Gynecol Reprod Biol. 2016;205:105-9.

ICMR -task free project. Multicentric case control study of ectopic pregnancy in India. J Obstet Gynaecol India. 1990;40:425-30.

Sharma JB, Sharma E, Sharma S, Dharmendra S. Female genital tuberculosis: Revisited. Ind J Med Res. 2018;148(Suppl):S71-S83.

Gandotra N, Zargar S. Risk factors associated with ectopic pregnancy in our sociodemographic setup. Int J Reprod Contracept Obstet Gynecol. 2020;9:4150.

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 193: tubal ectopic pregnancy. Obstet Gynecol. 2018;131(3):e91-103.

Lewis-Bliehall C, Rogers RG, Kammerer-Doak DN, Conway SC, Amaya C, Byrn F. Medical vs. Surgical treatment of ectopic pregnancy. The University of New Mexico's six-year experience. J Reprod Med. 2001;46(11):983-8.

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.






Original Research Articles