Epidemiological study of Ectopic Pregnancy at Sulaimani Maternity Teaching Hospital, Iraq: A cross-sectional study

Ectopic pregnancy (EP) remains a major cause of early pregnancy-related morbidity and mortality. It can significantly impact future fertility and is associated with various risk factors. To investigate the incidence, clinical profile, and risk factors of EP among admitted women to the tertiary hospital. A prospective, cross-sectional study was conducted on 393 women with early pregnancy at the Maternity Teaching Hospital, Sulaymaniyah, Iraq from January 2024 to April 2025. Collected data included patients' demographic characteristics, clinical data, and risk factors for EP, using a structured questionnaire. Then, diagnosis of EP was confirmed by serum β-hCG test and transvaginal ultrasonography. Management approaches were applied (manual, expectant, or surgical). Among studied women (n = 393) with early pregnancy, 79 (20.1%) were diagnosed with EP. The mean age of EP patients was 31 ± 4.47 years and mostly aged 30 to 39 years (44.3%), from urban area (68.4%), housewives (86.1%), gave birth to 2-4 children (62%), had 1-2 pregnancies (%). Frequent symptoms included lower abdominal pain (82.3%) and vaginal bleeding (67.1%) (P = .047). Major observed risk factors were previous C/S (54.4%), pelvic inflammatory disease (48.1%), and prior EP (11.4%) (P < .001). Tubal pregnancies constituted 82.3%, followed by C/S scar (15.2%), and rare cervical and ovarian sites (1.3%) (P < .001). Management was mainly surgical (50.6%), then expectant (25.3%) approach, and medical treatments (24.1%) (P = .049). The incidence of EP was higher than global estimates, likely due to the study population characteristics. However, this single-center study is not a representative of the regional epidemiology of ectopic pregnancy.