A clinical study of ectopic pregnancy in a tertiary care centre in Central India


  • Mridula Shrivastava Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
  • Hemlata Parashar Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
  • Jyoti Nath Modi Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India




Ectopic, Emergency, Pregnancy


Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. The incidence of ectopic pregnancy is on a rise globally. Risk factors and causes for ectopic pregnancy may vary with the setting and geographically.

Methods: A retrospective analysis of all operated ectopic pregnancies over a 5-year period; between June 2011 to May 2016, was done. Surgically confirmed cases were included in this study and a detailed analysis of presenting symptoms, age, parity and high risk factors was carried out.

Results: A total of 50 patients were operated for ectopic pregnancy at our hospital during the study period. Analysis was done for 47 of these due to incomplete data for 3 patients. Majority (62%) of patients belonged to the age group 20-29 years and were gravida 3 and above. Ninety two percent were ruptured ectopic. Sixty two percent ectopic pregnancies were on right side. The common presenting complaints were pain in abdomen (81%) and bleeding/spotting per vaginum (43%). The mean duration between onset of symptoms and reporting to hospital was one and a half day and the average time between admission to hospital and surgery was 9 hours. The ectopic pregnancies were managed surgically in all cases. No obvious risk factors were identified in 34% patients. Among the remaining, previous MTP (17%), previous ectopic (9%) and PID (7%) were identified risk factors. There was no mortality.

Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital. Screening of high risk cases, early diagnosis and early intervention reduces the morbidity and mortality in ectopic pregnancies.


Cantwell R, Clutton-Brock T, Coopaer G. Saving mother’s lives: reviewing maternal deaths to make motherhood safer:2006-2008.The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG. 2011;118:1-203.

Kirk E, Bottomley C, Bourne T. "Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location". Hum. Reprod. Update. 2014:20(2):250-61.

Ankum VM, Mol BW, Van der Veen F. Risk factors for ectopic pregnancy: a meta- analysis, Fertil Steril. 1996;65:1093-1099.

Zane SB, Kieke BA, Kendrick JS, Bruce C. Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. Matern Child Health J. 2002; 6:227.

Crochet JR, Bastian LA, Chireau MV. "Does this woman have an ectopic pregnancy?: the rational clinical examination systematic review". JAMA. 2013;309(16):1722-9.

Skipworth R. "A new clinical sign in ruptured ectopic pregnancy". Lancet. 2011;378(9809):27.

Mahboob U, Mazhar SB. "Management of ectopic pregnancy: a two-year study".Journal of Ayub Medical College, Abbottabad: JAMC. 2006;18(4): 34-7.

Priyadarshini B, Padmasri R, Jnaneshwari TL, Sowmya KP, Bhatara U, Hema V. Ectopic pregnancy: a cause for maternal morbidity. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;5(3):700-4.

Patel M, Chavda D, Prajapati S. A retrospective study of 100 cases of ectopic pregnancy: clinical presentation, site of ectopic and diagnosis evaluation. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016;5(12):4313-6.

Poonam Y, Uprety D, Banerjee B. Ectopic pregnancy-two years review from BPKIHS, Nepal. Kathmandu University Med J. 2005;3:365-9.

Rakhi MP, Nupur H, Agarwal A, Makkar P, Fatima A. Ectopic pregnancy: a devastating catastrophe. Sch J App Med Sci. 2014;2(3A):903-7.

Igwegbe AO, Eleje GU, Okpala BC. An appraisal of the management of ectopic pregnancy in a Nigerian tertiary hospital. Ann Med Health Sci Res. 2013;3(2):166-70

Perveen F, Tayyab S. Ruptured ectopic pregnancy: clinical presentation and management. J Surg Pak. 2007;12(2):47-51.

Shivakumar HC, Umashankar KM, Ramaraju HE. Analysis of forty cases of ectopic pregnancies in tertiary care hospital in South India. Indian J Basic Appl Med Res. 2013;3(1):235-41.

Hassan N, Zaheen Z, Jatoi N. Risk factors, clinical presentation and management of 62 cases of ectopic pregnancy at tertiary care centre. JLUMHS. 2009;8(3):238-41.

Shaikh NB, Shaikh S, Shaikh F. A clinical study of ectopic pregnancy. J Ayub Med Coll Abbottabad. 2014;26(2):178-81.

Asuri SS, Kalpana P. A clinical study of ectopic pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016;5(11):3750-3.

Jophy R, Thomas A, Mhaskar A. J Obst and Gyn India. 2002;52:55-8.

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

Saha PK et al. Int J Reprod Contracept Obstet Gynecol. 2016 Feb;5(2):367-70.

Marchbanks PA, Annegero JF, Coullan CB, Strathy JH, Kurland LT. Risk factors for ectopic pregnancy. A population based study. JAMA. 1988;259:1823-7.

Savitha Devi Y. Laparoscopic treatment of ectopic pregnancy. J Obst Gyn India. 2000;50:69.

ICMR task force project. Multicentric case control study of ectopic pregnancy in India. J Obst Gyn India. 1990;40:425-30.

Stabile I, Grudzinski JG. Ectopic pregnancy; what’s new? In Studd J editor. Progress in obstetrics and gynaecology, Edinburgh:Churchill Livinstone; 2000:11:281.

Eastman NJ, Hellman L. Williams Obst. 12th edition. New York: Appleton century crafts; 1961:130.

Bouyer J, Coste J, Shojaei T, Pouly J, Fernandez H. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, populationbased study in France. Am J Epidemiol. 2003;157(3):185-94.

Comprehensive Gynaecology, 3rd edition. Missouri, St Louis: Mosby; 1997:432.

DeCherney A, Minkin MJ, Spangler S: Contemporary management of ectopic pregnancy. J Reprod Med. 1981;26:519.

Douglas ES, Singleton HM, Crist T: Surgical management of tubal pregnancy: Effect on subsequent fertility. South Med J. 1969;62:954.

Panchal D, Vaishnav G, Solanki K. Study of Management in Patient with Ectopic Pregnancy. NJIRM. 2011;2(3):91-4.

Langer R, Bukovsky, Herman A. Conservative surgery for tubal pregnancy. Fertil Steril. 1982;38:427.

Deanna D, Caminiti MD, Kathleen L. Smith. An institutional review of the management of Ectopic pregnancy. J Gynecol Surg. 2006;22(2):47-56.

Lawani OL, Anozie OB, Ezeonu PO. Ectopic pregnancy: a life threatening gynecological emergency. Int J Women’s Health. 2013;19(5):515- 21.

Igwegbe AO, Eleje GU, Okpola BC. An appraisal of the management of ectopic pregnancy in a Nigerian Tertiary Hospital. Ann Med Health Science Res. 2013;3(2):166-70.

Majhi AK, Roy N, Karmakar KS, Banerjee PK. Ectopic pregnancy-An analysis of 180 cases. J Indian Med Assoc. 2007;105(6):308-12






Original Research Articles