A study of incidence, risk factors, clinical profile and management of 50 cases of ectopic pregnancy in a tertiary care teaching hospital

G. Ganitha, G. Anuradha


Background: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies in a tertiary care teaching hospital.

Methods: This was a prospective study of 50 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from August 2012 to September 2013. Relevant data of the 50 patients was tabulated and descriptive analysis was carried out.

Results: The incidence of ectopic pregnancy was 6.3 per 1000 deliveries. Majority of the patients (82%) belonged to 20-30 yrs age group. 70% of the women were multiparous. The commonest site of ectopic pregnancy was fallopian tube (92 %). Past history of pelvic inflammatory disease (40%), abortions (20%), abdominopelvic surgery (14%) and IUCD usage (12%) were among the important risk factors identified. 20% of the patients had no identifiable risk factor. The classical triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 56 % of the study population. The most important signs which guided the diagnosis of ectopic pregnancy were cervical excitation pain (74%), abdominal tenderness (72%), adnexal mass or fullness (68%) and tenderness in the fornix (68%). Clinical presentation, urinary pregnancy test, culdocentesis and ultrasound were the diagnostic tools used for diagnosis of ectopic pregnancy. The incidence of ruptured ectopic pregnancy was 86%. Majority of the patients underwent salpingectomy (96%). There was no maternal mortality in our study.

Conclusions: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.


Ectopic pregnancy, Pelvic inflammatory disease, Risk factors, Salpingectomy, Tubal pregnancy

Full Text:



Farquhar CM: Ectopic pregnancy. Lancet. 2005;366(9485):583-91.

Varma R, Gupta J. Tubal ectopic pregnancy. BMJ Clin Evid. 2009;1406.

Leke RJ, Goyaux N, Matsuda T, Thonneau PF. Ectopic pregnancy in Africa: a population-based study. Obstet Gynecol. 2004;103:692-97.

Thonneau P, Hijazi Y, Goyaux N, Calvez T, Keita N. Ectopic pregnancy in Conakry, Guinea.Bull World Health Organ. 2002;80:365-70.

Shetty VH, Gowda S, Lakshmidevi M. Role of ultra sonography in Diagnosis of ectopic pregnancy with clinical analysis and management in tertiary care hospital. J Obstet Gynecol Ind. 2014;64(5):354-57.

Jophy R, Thomas A, Mhaskar A. Ectopic pregnancy -5 year experience. J Obstet Gynecol Ind. 2002;52:55-8.

Gupta R, Porwal S, Swarnkar M, Sharma N, Maheshwari P. Incidence, trends and risk factors for ectopic pregnancies in a tertiary care hospital of Rajasthan. JPBMS. 2012;16(07):1-3.

Yadav A, Prakash A, Sharma C, Pegu B, Saha MK.Trends of ectopic pregnancies in Andaman and Nicobar Islands.Int JReprod Contracept Obstet Gynecol. 2017;6:15-9.

Gaddagi RA, Chandrashekhar AP. A Clinical Study of Ectopic Pregnancy. J Clin Diagn Res. 2012;6(5):867-9.

Shivakumar HC, Umashankar KM, Ramaraju HE. Analysis of forty cases of ectopic pregnancies in tertiary care hospital in south India. Indian Journal of Basic and Applied Medical Research; 2013: 3(1):235-241.

Wakankar R, Kedar K. Ectopic Pregnancy- A rising Trend. Int J Sci Stud. 2015;3(5):18-22.

Mufti S, Rather S, Mufti S, Rangrez RA, Wasiqa, Khalida. Ectopic pregnancy: an analysis of 114 cases. JK Practitioner. 2012;17(4):20-3.

Shukla DB, Jagtap SV, Kale PP, Thakkar HN.Study of ectopic pregnancy in a tertiary care centre.Int J Reprod Contracept Obstet Gynecol. 2017;6:975-9.

Yadav ST, Kaur S, Yadav SS. Ectopic pregnancy an obstetric emergency: retrospective study from medical college Ambala, Haryana, India.Int J Reprod Contracept Obstet Gynecol. 2016;5:2210-4.

Bhuria V, Nanda S, Chauhan M, Malhotra V. A retrospective analysis of ectopic pregnancy at a tertiary care centre: one year study. Int J Reprod Contracept Obstet Gynecol. 2016;5:2224-7.

Nair L, Peter N, Rose A. International Journal of Biomedical Research 2015;6(05):331-3.

Shobeiri F, Tehranian N, Nazari M. Trend of ectopic pregnancy and its main determinants in Hamadan province, Iran (2000-2010). BMC research notes. 2014;7(1):733.

Rakhi, Mital PL, Hooja N, Agarwal A, Makkar P, Andleeb F. Ectopic pregnancy: a devastating catastrophe.Sch J App Med Sci. 2014;2(3A):903-7.

Prasanna B, Jhansi CB, Swathi K, Shaik MV. A study on risk factors and clinical presentation of ectopic pregnancy in women attending a tertiary care centre. IAIM. 2016;3(1):90-6.

Moini A, Hosseini R, Jahangiri N, Shiva M, Akhoond MR. Risk factors for ectopic pregnancy: A case–control study. J Res Med Sci. 2014;19:844-9.

Parashi S, Moukhah S, Ashrafi M. Main risk factors for ectopic pregnancy: a case–control study in a sample of Iranian women. Int J Fertil Steril. 2014;8:147-54.

Simsek Y, Oguzhan A M. Analysis of ectopic pregnancies admitted to emergency department. Turk J Emerg Med. 2015;15(4):151–154.

Ragab A, Mesbah Y, El-Bahlol I, Fawzy M, Alsammani MA. Predictors of ectopic pregnancy in nulliparous women: A case-control study. Middle East Fertility Society Journal.2016;21(1):27-30.

Naseem I, Bari V, Nadeem N. Multiple parameters in the diagnosis of ectopic pregnancy. J Pak Med Assoc. 2005;55(2):74-6.

Awoleke JO, Adanikin AI, Awoleke AO. Ruptured tubal pregnancy: predictors of delays in seeking and obtaining care in a Nigerian population. Int J Women Health. 2015;7:141-7.