Evaluation of clinical presentation and maternal outcome of ectopic pregnancy in a tertiary care hospital: An observational cross-sectional study
Authors: Mandal Ratan , Hoque Injamam , Pan Avijit , Mandal Moumita , Maity Suman , Anjali Anjali , Pramanik Ananya , Banerjee Madhumanti 
Published: August 2024

Background: The implantation and growth of the blastocyst outside of the endometrial lining of the uterus cavity are known as ectopic pregnancy. In our nation, ectopic pregnancy continues to be a major cause of maternal mortality in the first trimester, accounting for about 9% of pregnancy-related deaths. It can have very bad and deadly consequences, including as severe bleeding and maternal death. Therefore, this study is critical to the prevention of problems and enhancement of maternal outcomes by early and correct diagnosis through clinical presentation and investigation.

Aim and Objectives: The study aimed to evaluate the clinical presentations and maternal outcomes of ectopic pregnancy cases attending a tertiary care hospital.

Materials and Methods: This cross-sectional observational study was conducted in a tertiary care hospital. The 12-month study ran from January 1, 2023, to December 31, 2023, in the Obstetrics and Gynecology Department of Midnapore Medical College and Hospital in West Bengal, India. This study comprised 100 diagnosed cases of ectopic pregnancy. To evaluate the age, socioeconomic status, gravida, gestational period, risk factors, clinical presentation, and maternal outcome of an ectopic pregnancy, data on these patients were recorded and statistical analysis was performed.

Results: Of the 100 diagnosed cases of ectopic pregnancy, 72% were aged 21–30, and all were from rural areas. Most patients (61%) had a poor socioeconomic status. The obstetric status varied, with G3 being the most common (33%). A majority (62%) presented between 6 and 8 weeks of amenorrhea. Risk factors included pelvic inflammatory disease (21%), previous surgery (21%), and abortions (16%). Common symptoms were amenorrhea (98%), abdominal pain (85%), and vaginal bleeding (66%). Physical examinations revealed forniceal fullness (72%) and tenderness (65%). Positive pregnancy tests were universal, and 82% had USG findings suggesting ectopic pregnancy. The right fallopian tube was the most common site (63%), with 86% presenting with ruptured ectopic pregnancies. Most (94%) required emergency surgery, predominantly salpingectomy (85%). Blood transfusions were needed in 60% of cases, and 20% required ICU admission. Post-operative complications occurred in 14% of patients, with no mortality reported during the study period.

Conclusion: Community education is crucial to urge women to attend health facilities as soon as they develop symptoms, as tubal rupture is a common occurrence in our system. For women who experience ectopic pregnancies, this strategy can greatly lower the risk of complications and improve outcomes. Overall, our study underscores the importance of early recognition, accurate diagnosis, and prompt intervention to optimize maternal outcomes in the management of ectopic pregnancy. By outlining the risk factors as well as the clinical course of ectopic pregnancy in our hospital setting, our findings aim to improve clinical practice and direct future research efforts in this field.