Management Approaches for Ectopic Pregnancies in a Tertiary Care Hospital

Background: Ectopic pregnancy is a chief causal factor to maternal morbidity and mortality, particularly in developing nations. This condition occurs when a fertilized egg implants outside the uterine cavity, requiring swift diagnosis and intervention to prevent life-threatening complications. The incidence, risk factors, clinical manifestations, management approaches, and outcomes of ectopic pregnancies vary significantly depending on demographic and healthcare factors. Aim: The aim of this study is to examine the clinical presentation, associated risk factors, treatment modalities, and outcomes in patients diagnosed with ectopic pregnancies. Methods: This prospective observational study was conducted over two years, from August 2022 to July 2024, at MKCG Medical College and Hospital, involving 180 patients diagnosed with ectopic pregnancies. Comprehensive patient data, including demographics, risk factors, clinical presentations, and past surgical or obstetric histories, were collected. Management was categorized as either medical or surgical, depending on the patient’s condition. Statistical analysis was performed using Microsoft Excel and SPSS Version 21.0. Statistical significance was evaluated using the Student’s t-test and Chi-square test. Results: The incidence of ectopic pregnancy was found to be 1.17%, with the highest occurrence in women aged 26-30 years. Hemoglobin levels between 7-9.9 gm% were observed in 41.6% of the patients. Ampullary tubal pregnancy was the most common site of implantation (85%), and 81.1% of cases involved ruptured ectopic pregnancies. Unilateral salpingectomy was the most frequently performed surgical procedure (88.3%). Blood transfusions were necessary in 53.8% of cases, and the mortality rate was 1.6%. Conclusion: Ectopic pregnancy continues to pose a serious health challenge with notable morbidity and mortality. Early diagnosis and timely management are essential to improving outcomes. Surgical intervention remains the primary treatment option, especially in cases of ruptured ectopic pregnancies. Recommendations: To reduce the morbidity and mortality associated with ectopic pregnancies, it is recommended to strengthen antenatal care, promote early ultrasound screening, and raise awareness among healthcare providers and patients regarding the risk factors for ectopic pregnancies.