Unveiling ectopic pregnancy in Mosul city (Iraq): critical insights into symptoms, risk profiles, imaging findings, and treatment outcomes

Background. Ectopic pregnancy (EP) is a leading obstetric emergency and a life-threatening condition that usually defines the implantation of a fertilized ovum outside of the uterine cavity, most frequently occurred in the fallopian tubes. Although global research has focused on understanding the clinical manifestations, risk factors and treatment strategies for EP, localized studies are important to describe regional variations that may have an impact in patient outcome. EP remains a significant cause of maternal morbidity and mortality, especially in resource-limited settings. The purpose: to assess the clinical characteristics, risk factors, ultrasound findings, and treatment outcomes of ectopic pregnancy in women attending an outpatient clinic and Al-Batool Teaching Hospital in Mosul. Materials and methods. This prospective observational study was conducted at Al-Batool Teaching Hospital in Mosul from February 2024 to March 2025. It involved hemodynamically stable outpatients aged 17–38 years with suspected EP. Diagnostic evaluations included standardized pelvic and transvaginal ultrasounds using DC-70 equipment with color Doppler. For inconclusive cases, follow-up clinical assessments and ultrasounds were performed every three days until a definitive diagnosis was achieved, ensuring accurate and comprehensive care. Results. The results showed pelvic pain in 51.3 % of patients, amenorrhea in 48.7 %, and vaginal bleeding in 15.4 %. Methotrexate treatment was successful in 25.6 %, while unilateral salpingectomy had a 48.7 % success rate. Risk factors were present in 69.2 % of women, mainly pelvic inflammatory diseases (35.9 %) and intrauterine device use (38.5 %). Fallopian tube pregnancies were most common (51.3 %). Hysterectomy was not performed in any case. Other symptoms and treatments showed lower positive rates. Conclusions. Ectopic pregnancy remains a critical concern due to its varied symptoms and risk factors. Most cases involved fallopian tubes, likely due to impaired tubal motility or inflammation, highlighting the need for early diagnosis and targeted interventions to prevent complications.