Hemodynamic havoc: complicated ectopic pregnancy may trigger acute kidney injury

Authors

  • Upma Narain Department of Microbiology and Immunology, Tejas Microdiagnostics, Prayagraj, Uttar Pradesh, India
  • Arvind Gupta Department of Nephrology, MLN Medical College, Prayagraj, Uttar Pradesh, India
  • Mona Dubey Department of Obstetrics and Gynecology, Panchsheel Diagnostic Centre Prayagraj, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20261271

Keywords:

Ectopic pregnancy, AKI, Complicated

Abstract

Background: The incidence of complicated ectopic pregnancies highlights the need for awareness of risk factors, as well as associated morbidity and mortality. This study aimed to determine the incidence of acute kidney injury (AKI) in patients with complicated ectopic pregnancy and to assess associated morbidity and mortality.

Methods: A retrospective observational study evaluated the incidence of AKI in patients with complicated ectopic pregnancy and assessed related morbidity and mortality at hospitals in Prayagraj, UP, from January 1, 2010, to December 31, 2024.

Results: A total of 180 ectopic pregnancies (EPs) were diagnosed, comprising 70 (38.89%) cases in primiparous and 110 (61.11%) in multiparous females. EP locations included tubular (83.8%), cervical (1.11%), ovarian (0.005%), and cesarean scar (14.44%), with an observed increase in cesarean scar implantations. Prior to admission to the nephrology intensive care unit (nephro ICU), salpingectomy was performed in 83.88% of cases, hysterectomy in 14.45%, and subtotal hysterectomy in 1.67%. In addition to severe haemorrhage, primary clinical findings were shock, septicemia, acute respiratory distress syndrome, oliguria, and multiple organ failure. Renal replacement therapy was initiated in 65 patients; among these, 46 (71.5%) received haemodialysis and 19 (15.84%) underwent plasmapheresis. The occurrence of these complications, particularly those necessitating RRT, was associated with a poor prognosis.

Conclusions: Early diagnosis of ectopic pregnancy reduces complications, morbidity, and mortality. Patients recovering from AKI must follow up with nephrology to ensure long-term health. Public awareness and training healthcare professionals in ultrasound for early detection are essential.

References

Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10-year population-based study of 1800 cases. Hum Reprod. 2002;17(12):3224-30.

Wallach EE, Tal J, Haddad S, Gordon N, Timor-Tritsch I. Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: a literature review from 1971 to 1993. Fertil Steril. 1996;66(1):1-12.

Godria PP, Darda MG, Modi DA, Rami BD. A retrospective study on ectopic pregnancy: incidence, clinical presentation, risk factors, treatment and morbidity and mortality associated with ectopic pregnancy- one year study. Int J Reprod Contracept Obstet Gynecol. 2023;12(4):1023-27.

Alkatout I, Honemeyer U, Strauss A, Tinelli A, Malvasi A, Jonat W, et al. Clinical diagnosis and treatment of ectopic pregnancy. Obstet Gynecol Surv. 2013;68(8):571-81.

Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute dialysis quality initiative workgroup. acute renal failure- definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:R204‑12.

Levin A, Stevens PE. Summary of KDIGO 2012 CKD guideline: behind the scenes, need for guidance, and a framework for moving forward. Kidney Int. 2014;85(1):49-61.

Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31:1250‑6.

Mullany K, Minneci M, Monjazeb R, C Coiado O. Overview of ectopic pregnancy diagnosis, management, and innovation. Womens Health. 2023;19:17455057231160349.

Stabile G, Mangino FP, Romano F, Zinicola G, Ricci G. Ectopic cervical pregnancy: treatment route. Medicina. 2020;56(6):293.

Dvash S, Cuckle H, Smorgick N, Vaknin Z, Padoa A, Maymon R. Increase rate of ruptured tubal ectopic pregnancy during the COVID-19 pandemic. Eur J Obstet Gynecol Reprod Biol. 2021;259:95-9.

Seow KM, Huang LW, Lin YH, Lin MY, Tsai YL, Hwang JL. Cesarean scar pregnancy: issues in management. Ultrasound Obstet Gynecol. 2004;23(3):247-53.

Kumari V, Kumar H, Datta MR. The importance of ectopic mindedness: scar ectopic pregnancy, a diagnostic dilemma. Cureus. 2021;13(2):e13089.

Lipscomb GH. Medical therapy for ectopic pregnancy. Semin Reprod Med. 2007;25(2):93-8.

The Practice Committee of the American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril. 2013;100(3):638-44.

Centers for Disease Control and Prevention. Ectopic pregnancy-- United States, 1990-1992. MMWR Morb Mortal Wkly Rep. 1995;44(3):46-8.

Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intens Care Med. 2021;47(11):1181-247.

Downloads

Published

2026-04-28

How to Cite

Narain, U., Gupta, A., & Dubey, M. (2026). Hemodynamic havoc: complicated ectopic pregnancy may trigger acute kidney injury. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 15(5), 1699–1702. https://doi.org/10.18203/2320-1770.ijrcog20261271

Issue

Section

Original Research Articles