Clinical profile, risk factors and management outcomes of ectopic pregnancy: a prospective study from a tertiary care hospital in Rajasthan

Abstract

Background: Ectopic pregnancy remains a major cause of maternal morbidity and mortality in early pregnancy, accounting for 2-4% of all pregnancies worldwide. Advances in transvaginal sonography (TVS) and serum β-hCG estimation have improved early detection, yet delayed diagnosis persists, particularly in resource-limited settings. This study aimed to evaluate the clinical profile, risk factors, and management outcomes of ectopic pregnancy in women presenting to a tertiary care hospital.

Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynecology at Ananta Institute of Medical Science and Research Centre, Rajsamand, over 12 months. A total of 58 patients with confirmed ectopic pregnancy were included. Detailed history, clinical examination, risk factor assessment, TVS, and β-hCG testing were performed. Treatment modality (medical, surgical, or conservative) was chosen based on hemodynamic stability, β-hCG levels, and imaging findings. Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 25.0. Results were expressed as frequencies and percentages.

Results: Most patients (60.3%) were in the 21-30-year age group. Common risk factors included pelvic inflammatory disease (22.4%), history of infertility treatment (17.2%), previous pelvic surgery (15.5%), and intrauterine contraceptive device use (13.8%). Abdominal pain (86.2%) and amenorrhea (79.3%) were the most frequent symptoms. The fallopian tube was the predominant site (84.5%), with the ampullary region most affected. Surgical management was required in 67.2% of cases, with salpingectomy being the most common procedure. Medical management with methotrexate was successful in 20.7%, while 12.1% were managed expectantly. Postoperative complications were minimal, with anemia and need for blood transfusion reported in 15.5%.

Conclusions: Ectopic pregnancy remains a significant health concern in reproductive-aged women. Early recognition of risk factors, timely diagnosis using β-hCG and TVS, and individualized management strategies can significantly improve maternal outcomes. Strengthening awareness and early referral systems remain critical in reducing morbidity and mortality.