Publication:

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

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.